const pptxgen = require("pptxgenjs");
const { execSync } = require("child_process");

const pres = new pptxgen();
pres.layout = "LAYOUT_16x9";
pres.title = "Brachytherapy Role in Physiotherapy for Cervical Cancer";
pres.author = "Orris Medical AI";

// ─── Color Palette ─────────────────────────────────────────────────────────────
const TEAL       = "006D77";  // dominant deep teal
const TEAL_DARK  = "004E57";  // darker teal for header bands
const TEAL_MED   = "218089";  // medium teal for accents
const TEAL_LIGHT = "83C5BE";  // light teal for dividers
const CREAM      = "EDF6F9";  // near-white slide background
const SAND       = "FFDDD2";  // warm accent (highlight boxes)
const ORANGE_ACC = "E29578";  // orange accent
const WHITE      = "FFFFFF";
const DARK_TEXT  = "1A1A2E";
const GRAY_TEXT  = "4A5568";

// ─── Reusable helpers ───────────────────────────────────────────────────────────

function addStyledSlide(titleText, subtitleText) {
  const slide = pres.addSlide();

  // Full background
  slide.addShape(pres.shapes.RECTANGLE, {
    x: 0, y: 0, w: 10, h: 5.625,
    fill: { color: CREAM },
    line: { color: CREAM }
  });

  // Top header band
  slide.addShape(pres.shapes.RECTANGLE, {
    x: 0, y: 0, w: 10, h: 1.1,
    fill: { color: TEAL_DARK },
    line: { color: TEAL_DARK }
  });

  // Teal accent stripe
  slide.addShape(pres.shapes.RECTANGLE, {
    x: 0, y: 1.1, w: 10, h: 0.08,
    fill: { color: TEAL_LIGHT },
    line: { color: TEAL_LIGHT }
  });

  // Title text
  slide.addText(titleText, {
    x: 0.4, y: 0.1, w: 9.2, h: 0.9,
    fontSize: 26, bold: true, color: WHITE, fontFace: "Calibri",
    valign: "middle", margin: 0
  });

  if (subtitleText) {
    slide.addText(subtitleText, {
      x: 0.4, y: 1.2, w: 9.2, h: 0.4,
      fontSize: 13, color: TEAL, fontFace: "Calibri", italic: true, margin: 0
    });
  }

  return slide;
}

function addBulletBox(slide, items, x, y, w, h, bgColor, textColor, fontSize) {
  slide.addShape(pres.shapes.ROUNDED_RECTANGLE, {
    x, y, w, h,
    fill: { color: bgColor || WHITE },
    line: { color: TEAL_LIGHT, pt: 1 },
    rectRadius: 0.08,
    shadow: { type: "outer", color: "000000", blur: 4, offset: 2, angle: 135, opacity: 0.08 }
  });

  const textItems = items.map((item, i) => {
    if (item.startsWith("##")) {
      return {
        text: item.replace("##", "").trim(),
        options: { bold: true, color: TEAL_DARK, fontSize: (fontSize || 13) + 1, breakLine: true }
      };
    }
    return {
      text: item,
      options: { bullet: { code: "25CF", color: ORANGE_ACC }, color: textColor || DARK_TEXT, fontSize: fontSize || 13, breakLine: i < items.length - 1 }
    };
  });

  slide.addText(textItems, {
    x: x + 0.15, y: y + 0.1, w: w - 0.3, h: h - 0.2,
    valign: "top", fontFace: "Calibri"
  });
}

function addIconBox(slide, iconChar, label, desc, x, y) {
  // Card bg
  slide.addShape(pres.shapes.ROUNDED_RECTANGLE, {
    x, y, w: 2.8, h: 1.8,
    fill: { color: WHITE }, line: { color: TEAL_LIGHT, pt: 1 }, rectRadius: 0.1,
    shadow: { type: "outer", color: "000000", blur: 6, offset: 2, angle: 135, opacity: 0.1 }
  });
  // Icon bg circle
  slide.addShape(pres.shapes.OVAL, {
    x: x + 0.95, y: y + 0.12, w: 0.9, h: 0.9,
    fill: { color: SAND }, line: { color: ORANGE_ACC, pt: 1 }
  });
  slide.addText(iconChar, { x: x + 0.95, y: y + 0.13, w: 0.9, h: 0.85, fontSize: 22, align: "center", valign: "middle", fontFace: "Segoe UI Emoji" });
  slide.addText(label, { x: x + 0.1, y: y + 1.08, w: 2.6, h: 0.32, fontSize: 11.5, bold: true, color: TEAL_DARK, align: "center", fontFace: "Calibri" });
  slide.addText(desc, { x: x + 0.1, y: y + 1.38, w: 2.6, h: 0.35, fontSize: 10, color: GRAY_TEXT, align: "center", fontFace: "Calibri" });
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 1 — TITLE SLIDE
// ═══════════════════════════════════════════════════════════════════════════════
{
  const slide = pres.addSlide();

  // Full teal background
  slide.addShape(pres.shapes.RECTANGLE, {
    x: 0, y: 0, w: 10, h: 5.625,
    fill: { color: TEAL_DARK }, line: { color: TEAL_DARK }
  });

  // Diagonal accent
  slide.addShape(pres.shapes.RECTANGLE, {
    x: 6.5, y: 0, w: 3.5, h: 5.625,
    fill: { color: TEAL_MED }, line: { color: TEAL_MED }
  });

  // Vertical accent line
  slide.addShape(pres.shapes.RECTANGLE, {
    x: 6.3, y: 0, w: 0.15, h: 5.625,
    fill: { color: TEAL_LIGHT }, line: { color: TEAL_LIGHT }
  });

  // Decorative circles
  slide.addShape(pres.shapes.OVAL, { x: 7.2, y: 0.3, w: 1.4, h: 1.4, fill: { color: TEAL_DARK, transparency: 40 }, line: { color: TEAL_DARK } });
  slide.addShape(pres.shapes.OVAL, { x: 8.1, y: 3.8, w: 1.8, h: 1.8, fill: { color: TEAL_DARK, transparency: 40 }, line: { color: TEAL_DARK } });

  // Top label
  slide.addShape(pres.shapes.RECTANGLE, {
    x: 0.4, y: 0.45, w: 2.8, h: 0.35,
    fill: { color: ORANGE_ACC }, line: { color: ORANGE_ACC }
  });
  slide.addText("ONCOLOGY PHYSIOTHERAPY", {
    x: 0.4, y: 0.45, w: 2.8, h: 0.35,
    fontSize: 9, color: WHITE, bold: true, align: "center", valign: "middle", fontFace: "Calibri"
  });

  // Main title
  slide.addText("Brachytherapy", {
    x: 0.4, y: 1.05, w: 5.7, h: 0.9,
    fontSize: 38, bold: true, color: WHITE, fontFace: "Calibri", valign: "bottom"
  });

  slide.addText("Role in Physiotherapy", {
    x: 0.4, y: 1.85, w: 5.7, h: 0.65,
    fontSize: 28, bold: false, color: TEAL_LIGHT, fontFace: "Calibri"
  });

  slide.addText("for Cervical Cancer", {
    x: 0.4, y: 2.4, w: 5.7, h: 0.65,
    fontSize: 28, bold: true, color: SAND, fontFace: "Calibri"
  });

  // Divider line
  slide.addShape(pres.shapes.RECTANGLE, {
    x: 0.4, y: 3.2, w: 5.5, h: 0.04,
    fill: { color: ORANGE_ACC }, line: { color: ORANGE_ACC }
  });

  slide.addText("Comprehensive Management & Rehabilitation", {
    x: 0.4, y: 3.35, w: 5.5, h: 0.4,
    fontSize: 13, color: CREAM, fontFace: "Calibri", italic: true
  });

  slide.addText("April 2026", {
    x: 0.4, y: 5.1, w: 2, h: 0.3,
    fontSize: 10, color: TEAL_LIGHT, fontFace: "Calibri"
  });
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 2 — OVERVIEW OF CERVICAL CANCER & RADIATION
// ═══════════════════════════════════════════════════════════════════════════════
{
  const slide = addStyledSlide("Cervical Cancer: Overview & Radiation Rationale", "Background & Clinical Context");

  // Two-column layout
  addBulletBox(slide, [
    "## Epidemiology",
    "4th most common female malignancy worldwide",
    "Squamous cell carcinoma: ~70-80% of cases",
    "Adenocarcinoma: ~20-25% of cases",
    "5-year survival: ~70% stage I, ~60% stage II, ~45% stage III"
  ], 0.3, 1.65, 4.5, 2.6, WHITE, DARK_TEXT, 12);

  addBulletBox(slide, [
    "## Why Radiation?",
    "Radiotherapy can treat ALL stages of cervical cancer",
    "Comparable outcomes to surgery for early-stage disease",
    "Allows organ preservation (vs. radical surgery)",
    "Chemoradiation is standard for advanced disease (IIB–IV)",
    "EBRT + Brachytherapy: cornerstone of curative intent"
  ], 5.0, 1.65, 4.65, 2.6, WHITE, DARK_TEXT, 12);

  // Bottom info bar
  slide.addShape(pres.shapes.RECTANGLE, {
    x: 0.3, y: 4.5, w: 9.4, h: 0.85,
    fill: { color: TEAL }, line: { color: TEAL }, rectRadius: 0.06
  });
  slide.addText("Key Principle:  External beam radiation (EBRT) reduces tumor bulk → Brachytherapy delivers high-dose boost directly to residual tumor", {
    x: 0.5, y: 4.55, w: 9.0, h: 0.72,
    fontSize: 12.5, color: WHITE, fontFace: "Calibri", bold: false, valign: "middle"
  });
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 3 — WHAT IS BRACHYTHERAPY?
// ═══════════════════════════════════════════════════════════════════════════════
{
  const slide = addStyledSlide("What is Brachytherapy?", "Radiation from Within");

  // Definition box
  slide.addShape(pres.shapes.RECTANGLE, {
    x: 0.3, y: 1.65, w: 9.4, h: 0.75,
    fill: { color: TEAL }, line: { color: TEAL }
  });
  slide.addText([
    { text: "Definition: ", options: { bold: true, color: SAND } },
    { text: "A form of radiation therapy where a radioactive source is placed onto or inside the treatment volume (tumour). Dose falls off rapidly (inverse square law), sparing healthy tissues.", options: { color: WHITE } }
  ], { x: 0.5, y: 1.68, w: 9.0, h: 0.68, fontSize: 12.5, fontFace: "Calibri", valign: "middle" });

  // 3 key feature cards
  const features = [
    ["📍", "Localised Action", "Radiation confined\nnear the source"],
    ["🔢", "Inverse Square Law", "Dose drops sharply\nwith distance"],
    ["💊", "High-Dose Delivery", "Very high doses\nto tumour target"],
    ["⚕️", "OAR Sparing", "Bladder & rectum\nprotected"]
  ];

  const startX = [0.3, 2.75, 5.2, 7.65];
  features.forEach((f, i) => {
    addIconBox(slide, f[0], f[1], f[2], startX[i], 2.6);
  });

  // Bottom note
  slide.addText("Greek: brachy = short distance | Isotope: Iridium-192 (HDR) most common in modern practice", {
    x: 0.4, y: 5.12, w: 9.2, h: 0.35,
    fontSize: 10.5, color: TEAL_MED, italic: true, fontFace: "Calibri", align: "center"
  });
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 4 — TYPES OF BRACHYTHERAPY
// ═══════════════════════════════════════════════════════════════════════════════
{
  const slide = addStyledSlide("Types of Brachytherapy for Cervical Cancer", "Techniques & Delivery Methods");

  // LDR box
  addBulletBox(slide, [
    "## LDR — Low Dose Rate",
    "Dose rate < 0.4 Gy/hour",
    "Isotope: Cesium-137 (Cs-137)",
    "Inpatient admission required (1-3 days)",
    "Patient immobilized during treatment",
    "DVT prophylaxis and radiation shielding needed",
    "Largely replaced by HDR in modern practice"
  ], 0.3, 1.65, 4.5, 2.8, WHITE, DARK_TEXT, 12);

  // HDR box
  addBulletBox(slide, [
    "## HDR — High Dose Rate",
    "Dose rate > 12 Gy/hour",
    "Isotope: Iridium-192 (Ir-192) via remote afterloader",
    "Outpatient — treatment takes only minutes",
    "4–5 fractions over the treatment course",
    "No prolonged immobilization",
    "Modern standard: image-guided (CT/MRI)"
  ], 5.0, 1.65, 4.65, 2.8, WHITE, DARK_TEXT, 12);

  // Interstitial note
  slide.addShape(pres.shapes.RECTANGLE, {
    x: 0.3, y: 4.62, w: 9.4, h: 0.75,
    fill: { color: SAND }, line: { color: ORANGE_ACC, pt: 1 }
  });
  slide.addText([
    { text: "Interstitial Brachytherapy: ", options: { bold: true, color: TEAL_DARK } },
    { text: "Hollow needles implanted directly into the tumour — used for bulky/irregular tumours where intracavitary applicators cannot achieve adequate coverage.", options: { color: DARK_TEXT } }
  ], { x: 0.5, y: 4.65, w: 9.0, h: 0.68, fontSize: 12, fontFace: "Calibri", valign: "middle" });
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 5 — TREATMENT PROTOCOL
// ═══════════════════════════════════════════════════════════════════════════════
{
  const slide = addStyledSlide("Brachytherapy Treatment Protocol", "Sequence, Dosimetry & Planning");

  // Timeline arrows
  const steps = [
    { label: "EBRT", sub: "25-28 fractions\n5 weeks pelvic radiation" },
    { label: "Week 4", sub: "Brachytherapy\nintroduced concurrently" },
    { label: "Applicator\nPlacement", sub: "Tandem + ring/ovoid\nunder anesthesia" },
    { label: "3D Imaging", sub: "CT or MRI with\napplicators in situ" },
    { label: "HDR\nFraction", sub: "Remote Ir-192\nsource delivery" }
  ];

  const boxW = 1.75;
  const startX = 0.25;
  const gap = 0.12;
  const y = 1.75;
  const h = 1.4;

  steps.forEach((s, i) => {
    const x = startX + i * (boxW + gap);
    // Arrow shape bg
    slide.addShape(pres.shapes.ROUNDED_RECTANGLE, {
      x, y, w: boxW, h,
      fill: { color: i % 2 === 0 ? TEAL : TEAL_MED },
      line: { color: TEAL_DARK },
      rectRadius: 0.07
    });
    slide.addText(s.label, {
      x: x + 0.05, y: y + 0.1, w: boxW - 0.1, h: 0.5,
      fontSize: 13, bold: true, color: WHITE, align: "center", fontFace: "Calibri"
    });
    slide.addText(s.sub, {
      x: x + 0.05, y: y + 0.6, w: boxW - 0.1, h: 0.75,
      fontSize: 10, color: CREAM, align: "center", fontFace: "Calibri"
    });

    // Arrow connector
    if (i < steps.length - 1) {
      slide.addShape(pres.shapes.RIGHT_ARROW, {
        x: x + boxW, y: y + 0.55, w: gap + 0.05, h: 0.3,
        fill: { color: ORANGE_ACC }, line: { color: ORANGE_ACC }
      });
    }
  });

  // Dosimetry box
  addBulletBox(slide, [
    "## Modern 3D Image-Guided Adaptive Brachytherapy (IGABT)",
    "HR-CTV D90: 8,500–9,500 cGy cumulative (GEC-ESTRO guidelines)",
    "Bladder constraint: D2cc < 90 Gy EQD2 | Rectum/Sigmoid: D2cc < 75 Gy EQD2",
    "Imaging at each insertion: plan adapted to tumour shrinkage",
    "Tumour control dose depends on tumour volume"
  ], 0.3, 3.3, 9.4, 2.05, WHITE, DARK_TEXT, 12);
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 6 — PHYSIOTHERAPY ROLE: OVERVIEW
// ═══════════════════════════════════════════════════════════════════════════════
{
  const slide = addStyledSlide("Role of Physiotherapy in Brachytherapy", "Pre-, Peri- and Post-Treatment Rehabilitation");

  // Phase banner
  const phases = [
    { label: "PRE-TREATMENT", color: TEAL_DARK, sub: "Assessment &\nConditioning" },
    { label: "DURING BT", color: TEAL_MED, sub: "Comfort &\nSafety" },
    { label: "ACUTE POST", color: ORANGE_ACC, sub: "Early Rehab\n& Education" },
    { label: "LONG-TERM", color: TEAL, sub: "Chronic Sequelae\nManagement" }
  ];

  phases.forEach((p, i) => {
    const x = 0.3 + i * 2.38;
    slide.addShape(pres.shapes.RECTANGLE, {
      x, y: 1.65, w: 2.2, h: 0.5,
      fill: { color: p.color }, line: { color: p.color }
    });
    slide.addText(p.label, { x, y: 1.65, w: 2.2, h: 0.5, fontSize: 10.5, bold: true, color: WHITE, align: "center", valign: "middle", fontFace: "Calibri" });
    slide.addShape(pres.shapes.RECTANGLE, {
      x, y: 2.15, w: 2.2, h: 0.6,
      fill: { color: CREAM }, line: { color: p.color, pt: 1 }
    });
    slide.addText(p.sub, { x: x + 0.05, y: 2.15, w: 2.1, h: 0.6, fontSize: 10, color: p.color, align: "center", valign: "middle", fontFace: "Calibri", bold: true });
  });

  // Core roles
  addBulletBox(slide, [
    "## Key Physiotherapy Domains",
    "Pelvic floor rehabilitation: strengthening and coordination after radiation damage",
    "Lymphoedema management: compression therapy for lower limb/genital oedema",
    "Vaginal stenosis prevention: education on use of vaginal dilators post-RT",
    "Pain management: manual therapy, TENS, heat/cold modalities",
    "Functional mobility and fatigue management",
    "Bladder & bowel dysfunction rehabilitation (incontinence, urgency)"
  ], 0.3, 2.95, 9.4, 2.4, WHITE, DARK_TEXT, 12);
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 7 — PELVIC FLOOR REHABILITATION
// ═══════════════════════════════════════════════════════════════════════════════
{
  const slide = addStyledSlide("Pelvic Floor Rehabilitation Post-Brachytherapy", "Targeting Radiation-Induced Pelvic Dysfunction");

  addBulletBox(slide, [
    "## Radiation Effects on Pelvic Floor",
    "Radiation-induced vasculitis and fibrosis → pelvic floor weakness",
    "Bladder fistula rate: 1.4–5.3% after pelvic RT",
    "Other serious toxicity (stricture, stenosis): 6.4–8.1%",
    "Vaginal fibrosis and stenosis — especially in postmenopausal patients"
  ], 0.3, 1.65, 4.5, 2.5, WHITE, DARK_TEXT, 12);

  addBulletBox(slide, [
    "## Physiotherapy Interventions",
    "Kegel (pelvic floor muscle) exercises: progressive resistance programme",
    "Biofeedback-assisted pelvic floor training",
    "Vaginal dilator programme: prevents stenosis, maintains sexual function",
    "Bladder retraining protocols for urgency/frequency",
    "Bowel management: dietary advice + core stabilisation",
    "Coordinate with multidisciplinary team (oncologist, nurse specialist)"
  ], 5.0, 1.65, 4.65, 2.5, WHITE, DARK_TEXT, 12);

  // Acute vs chronic box
  slide.addShape(pres.shapes.RECTANGLE, {
    x: 0.3, y: 4.32, w: 4.5, h: 1.02,
    fill: { color: SAND }, line: { color: ORANGE_ACC, pt: 1 }
  });
  slide.addText([
    { text: "ACUTE (during/after RT): ", options: { bold: true, color: TEAL_DARK } },
    { text: "Diarrhoea, bladder cramps, nausea, frequency — managed with dietary modification, antispasmodics, physio support", options: { color: DARK_TEXT } }
  ], { x: 0.45, y: 4.35, w: 4.2, h: 0.96, fontSize: 11, fontFace: "Calibri", valign: "middle" });

  slide.addShape(pres.shapes.RECTANGLE, {
    x: 5.0, y: 4.32, w: 4.65, h: 1.02,
    fill: { color: TEAL }, line: { color: TEAL_DARK, pt: 1 }
  });
  slide.addText([
    { text: "CHRONIC (months–years post-RT): ", options: { bold: true, color: SAND } },
    { text: "Fibrosis, fistulae, lymphoedema — require ongoing physio, specialist MDT, and sometimes surgical management", options: { color: WHITE } }
  ], { x: 5.15, y: 4.35, w: 4.35, h: 0.96, fontSize: 11, fontFace: "Calibri", valign: "middle" });
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 8 — LYMPHOEDEMA & MOBILITY
// ═══════════════════════════════════════════════════════════════════════════════
{
  const slide = addStyledSlide("Lymphoedema Management & Functional Mobility", "Secondary Physiotherapy Priorities");

  // Left column
  addBulletBox(slide, [
    "## Lower Limb Lymphoedema",
    "Pelvic node irradiation disrupts lymphatic drainage",
    "Affects up to 30% of patients after pelvic RT + lymphadenectomy",
    "Complete Decongestive Therapy (CDT):",
    "  → Manual lymphatic drainage (MLD)",
    "  → Multilayer compression bandaging",
    "  → Therapeutic exercises",
    "  → Skin and nail care"
  ], 0.3, 1.65, 4.5, 3.1, WHITE, DARK_TEXT, 11.5);

  // Right column
  addBulletBox(slide, [
    "## Fatigue & Functional Rehabilitation",
    "Cancer-related fatigue: most common patient complaint",
    "Graded aerobic exercise programme (walking, cycling)",
    "Resistance training: lower limb and core strengthening",
    "Energy conservation strategies and activity pacing",
    "Hip flexor and iliopsoas stretching post-pelvic RT",
    "Gait retraining if lymphoedema affects mobility",
    "Return-to-work & activity-of-daily-life planning"
  ], 5.0, 1.65, 4.65, 3.1, WHITE, DARK_TEXT, 11.5);

  slide.addShape(pres.shapes.RECTANGLE, {
    x: 0.3, y: 4.92, w: 9.4, h: 0.45,
    fill: { color: TEAL_MED }, line: { color: TEAL_MED }
  });
  slide.addText("Evidence base: Supervised exercise programmes reduce fatigue, improve QoL and functional outcomes in gynaecological cancer survivors", {
    x: 0.4, y: 4.94, w: 9.2, h: 0.4,
    fontSize: 11, color: WHITE, fontFace: "Calibri", italic: true, valign: "middle"
  });
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 9 — RADIATION COMPLICATIONS & PHYSIO ROLE
// ═══════════════════════════════════════════════════════════════════════════════
{
  const slide = addStyledSlide("Managing Radiation Complications", "Physiotherapy Contribution to Side-Effect Management");

  // 3-column complication cards
  const cols = [
    {
      title: "Radiation Proctopathy",
      color: TEAL_DARK,
      items: [
        "Rectal bleeding post-pelvic RT",
        "Bowel urgency & incontinence",
        "Physio role: bowel retraining",
        "Pelvic floor coordination training",
        "MDT with gastroenterologist",
        "Dietary fibre modification education"
      ]
    },
    {
      title: "Bladder Dysfunction",
      color: TEAL_MED,
      items: [
        "Urgency, frequency, incontinence",
        "Radiation cystitis symptoms",
        "Physio role: bladder diary keeping",
        "Bladder retraining schedule",
        "Pelvic floor muscle training",
        "Biofeedback for sphincter control"
      ]
    },
    {
      title: "Vaginal Stenosis & Sexual Health",
      color: ORANGE_ACC,
      items: [
        "Fibrosis → vaginal narrowing",
        "Sexual dysfunction common post-RT",
        "Physio role: dilator therapy programme",
        "Pelvic floor relaxation techniques",
        "Patient education on lubricants",
        "Sexual health counselling referral"
      ]
    }
  ];

  cols.forEach((col, i) => {
    const x = 0.3 + i * 3.22;
    slide.addShape(pres.shapes.RECTANGLE, {
      x, y: 1.65, w: 3.0, h: 0.42,
      fill: { color: col.color }, line: { color: col.color }
    });
    slide.addText(col.title, {
      x, y: 1.65, w: 3.0, h: 0.42,
      fontSize: 11.5, bold: true, color: WHITE, align: "center", valign: "middle", fontFace: "Calibri"
    });
    addBulletBox(slide, col.items, x, 2.07, 3.0, 3.25, WHITE, DARK_TEXT, 11);
  });
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 10 — POSITIONING & IMMOBILISATION DURING BT
// ═══════════════════════════════════════════════════════════════════════════════
{
  const slide = addStyledSlide("Physiotherapy During Brachytherapy Procedures", "Patient Positioning, Comfort & DVT Prevention");

  addBulletBox(slide, [
    "## During LDR Brachytherapy (Inpatient)",
    "Patient immobilised for 1–3 days with applicators in situ",
    "DVT prophylaxis: LMWH, compression stockings, ankle exercises",
    "Physiotherapist role: supervised gentle ankle pumps & isometrics",
    "Pressure ulcer prevention: repositioning within permitted range",
    "Respiratory exercises: deep breathing, coughing techniques",
    "Psychological support: managing anxiety during confinement"
  ], 0.3, 1.65, 4.5, 3.25, WHITE, DARK_TEXT, 12);

  addBulletBox(slide, [
    "## During HDR Brachytherapy (Outpatient)",
    "Treatment takes only minutes — minimal immobilisation",
    "Pre-procedure: relaxation techniques to reduce anxiety",
    "Post-procedure: assist patient to mobilise safely",
    "Nausea & discomfort: TENS, positioning advice",
    "Pain management after applicator placement",
    "Education on what to expect between fractions",
    "Home exercise programme maintenance during treatment"
  ], 5.0, 1.65, 4.65, 3.25, WHITE, DARK_TEXT, 12);

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    x: 0.3, y: 5.07, w: 9.4, h: 0.33,
    fill: { color: TEAL }, line: { color: TEAL }
  });
  slide.addText("Intraoperative real-time ultrasound guidance during tandem placement: Reduces uterine perforation (~9% risk) — physiotherapist assists with patient positioning", {
    x: 0.45, y: 5.08, w: 9.1, h: 0.3,
    fontSize: 10.5, color: WHITE, fontFace: "Calibri", valign: "middle"
  });
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 11 — MULTIDISCIPLINARY TEAM
// ═══════════════════════════════════════════════════════════════════════════════
{
  const slide = addStyledSlide("Multidisciplinary Team & Physiotherapy Integration", "The Physio as Core MDT Member");

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    x: 3.9, y: 2.1, w: 2.2, h: 1.4,
    fill: { color: TEAL_DARK }, line: { color: TEAL_DARK }
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    x: 3.9, y: 2.1, w: 2.2, h: 1.4,
    fontSize: 13, bold: true, color: WHITE, align: "center", valign: "middle", fontFace: "Calibri"
  });

  // Surrounding roles
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    { x: 0.2, y: 1.65, label: "Radiation\nOncologist", sub: "EBRT & BT planning,\ndose prescription" },
    { x: 3.8, y: 1.35, label: "Medical\nPhysicist", sub: "Dosimetry, inverse\nsquare law calcs" },
    { x: 7.3, y: 1.65, label: "Gynaecologic\nOncologist", sub: "Surgery, staging,\nstent placement" },
    { x: 0.2, y: 3.6, label: "Physiotherapist", sub: "Rehab, pelvic floor,\nlymphoedema, mobility" },
    { x: 3.8, y: 4.15, label: "Oncology\nNurse", sub: "Care co-ordination,\npatient education" },
    { x: 7.3, y: 3.6, label: "Psycho-\nOncologist", sub: "Anxiety, depression,\nsexual health" }
  ];

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    slide.addShape(pres.shapes.ROUNDED_RECTANGLE, {
      x: r.x, y: r.y, w: 2.3, h: 1.15,
      fill: { color: r.label.includes("Physio") ? SAND : WHITE },
      line: { color: r.label.includes("Physio") ? ORANGE_ACC : TEAL_LIGHT, pt: r.label.includes("Physio") ? 2 : 1 },
      rectRadius: 0.08
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      x: r.x + 0.05, y: r.y + 0.08, w: 2.2, h: 0.45,
      fontSize: 11.5, bold: true, color: r.label.includes("Physio") ? TEAL_DARK : TEAL, align: "center", fontFace: "Calibri"
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      fontSize: 9.5, color: GRAY_TEXT, align: "center", fontFace: "Calibri"
    });
  });
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 12 — SUMMARY & KEY TAKEAWAYS
// ═══════════════════════════════════════════════════════════════════════════════
{
  const slide = pres.addSlide();

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    x: 0, y: 0, w: 10, h: 5.625,
    fill: { color: TEAL_DARK }, line: { color: TEAL_DARK }
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    x: 0.4, y: 0.1, w: 9.2, h: 0.85,
    fontSize: 26, bold: true, color: WHITE, valign: "middle", fontFace: "Calibri"
  });

  const points = [
    ["01", "Brachytherapy is ESSENTIAL", "Intracavitary/interstitial BT delivers the crucial dose boost to the cervical tumour — modern 3D IGABT has halved toxicity vs. 2D"],
    ["02", "Physiotherapy spans the continuum", "From pre-treatment conditioning to long-term chronic side-effect management — physio is involved at every stage"],
    ["03", "Pelvic floor is central", "Radiation causes fibrosis, incontinence, stenosis — targeted PFMT and dilator therapy prevent significant disability"],
    ["04", "Lymphoedema demands specialist care", "CDT (MLD + compression + exercise) must be initiated early; affects up to 30% post-pelvic RT"],
    ["05", "MDT collaboration is non-negotiable", "Physiotherapist must work with radiation oncologist, gynaecologist, and nurse to deliver safe, timely rehabilitation"]
  ];

  points.forEach((p, i) => {
    const y = 1.2 + i * 0.85;
    // Number badge
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      x: 0.3, y: y + 0.12, w: 0.55, h: 0.55,
      fill: { color: ORANGE_ACC }, line: { color: ORANGE_ACC }
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      x: 0.3, y: y + 0.12, w: 0.55, h: 0.55,
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  slide.addText("Source: Berek & Novak's Gynecology | Grainger & Allison's Diagnostic Radiology | Berek & Novak's Gynecology, pp. 2252–2265", {
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}

// ─── Write file ─────────────────────────────────────────────────────────────────
pres.writeFile({ fileName: "/home/daytona/workspace/brachytherapy-cervical-ppt/Brachytherapy_Cervical_Cancer_Physiotherapy.pptx" })
  .then(() => console.log("✅ Presentation saved successfully!"))
  .catch(err => { console.error("❌ Error:", err); process.exit(1); });