Tomorrow is my psm viva. And I don't know nothing about ADD . And external will ask from this slide. Help me to remember all this point in easy language

Reading File

Running Command

cd /home/daytona/workspace/attachments/1b0203a1-9def-440a-ac6b-e70df4b1ac98/ && python -m markitdown "Acute diarrhoeal diseases.pptx" 2>/dev/null

Running Command

cd /home/daytona/workspace/attachments/1b0203a1-9def-440a-ac6b-e70df4b1ac98/ && python3 -c " from pptx import Presentation prs = Presentation('Acute diarrhoeal diseases.pptx') for i, slide in enumerate(prs.slides): print(f'=== SLIDE {i+1} ===') for shape in slide.shapes: if hasattr(shape, 'text') and shape.text.strip(): print(shape.text) print() "

Running Command

pip install python-pptx --quiet --user 2>&1 | tail -3

Running Command

cd /home/daytona/workspace/attachments/1b0203a1-9def-440a-ac6b-e70df4b1ac98/ && python3 -c " from pptx import Presentation from pptx.util import Pt import re prs = Presentation('Acute diarrhoeal diseases.pptx') for i, slide in enumerate(prs.slides): print(f'=== SLIDE {i+1} ===') for shape in slide.shapes: if hasattr(shape, 'text_frame'): for para in shape.text_frame.paragraphs: text = para.text.strip() if text: print(text) print() " 2>&1

Running Command

cd /home/daytona/workspace/attachments/1b0203a1-9def-440a-ac6b-e70df4b1ac98/ && python3 -c " from pptx import Presentation from pptx.enum.shapes import MSO_SHAPE_TYPE import os prs = Presentation('Acute diarrhoeal diseases.pptx') os.makedirs('/home/daytona/workspace/add_slides', exist_ok=True) for i, slide in enumerate(prs.slides): for j, shape in enumerate(slide.shapes): if shape.shape_type == MSO_SHAPE_TYPE.PICTURE: img = shape.image ext = img.ext fname = f'/home/daytona/workspace/add_slides/slide{i+1}_img{j}.{ext}' with open(fname, 'wb') as f: f.write(img.blob) print(f'Saved: {fname}') "

Running Command

# Convert tiff to png for analysis for f in /home/daytona/workspace/add_slides/*.tiff; do base="${f%.tiff}" convert "$f" "${base}.png" 2>/dev/null && echo "Converted: ${base}.png" done

Running Command

python3 -c " from PIL import Image import os for f in os.listdir('/home/daytona/workspace/add_slides/'): if f.endswith('.tiff'): path = f'/home/daytona/workspace/add_slides/{f}' out = path.replace('.tiff', '.png') try: img = Image.open(path) img.save(out) print(f'Converted: {out}') except Exception as e: print(f'Failed {f}: {e}') "

Running Command

cd /home/daytona/workspace/attachments/1b0203a1-9def-440a-ac6b-e70df4b1ac98/ && python3 -c " from pptx import Presentation from pptx.util import Pt prs = Presentation('Acute diarrhoeal diseases.pptx') for i, slide in enumerate(prs.slides): has_content = False content = [] for shape in slide.shapes: # Tables if shape.has_table: has_content = True content.append('[TABLE]') for row in shape.table.rows: row_text = ' | '.join(cell.text.strip() for cell in row.cells) if row_text.strip('| '): content.append(row_text) # Text frames elif hasattr(shape, 'text_frame'): for para in shape.text_frame.paragraphs: text = para.text.strip() if text and text not in [str(i+1), '.']: content.append(text) has_content = True if has_content or content: print(f'=== SLIDE {i+1} ===') for c in content: print(c) print() " 2>&1 | head -400

analyse_media

I have all the text content from the slides. I now have enough information to create a comprehensive, easy-to-remember study guide. Let me compile it now.

📚 Acute Diarrhoeal Diseases (ADD) - PSM Viva Study Guide

Don't panic! Here's everything from your slides in simple, easy-to-remember language. I've organized it exactly as the external will ask.

1. DEFINITION (Most basic question!)

Diarrhoea = Change in:

Consistency (watery/loose stool) + Frequency (>3 times/day)

Simple trick: "3 or more watery stools per day = Diarrhoea"

2. CLASSIFICATION (4 types)

Type	Duration	Key Point
Acute watery diarrhoea	<4 weeks	Watery loose stool
Acute bloody diarrhoea (Dysentery)	<4 weeks	Blood/mucus in stool
Persistent diarrhoea	>14 days	Between acute & chronic
Chronic diarrhoea	>4 weeks	Long-standing
Diarrhoea with malnutrition	-	Marasmus/Kwashiorkor

Viva tip: MCC (Most Common Cause) of dysentery = Shigella

3. EPIDEMIOLOGY (Remember these numbers!)

Global (WHO):

2nd leading cause of death in children under 5
1.7 billion cases of childhood diarrhoea every year
525,000 children under 5 die each year from diarrhoea
80% of deaths occur in the first 2 years of life
Main cause of death = Dehydration (other causes: septic shock, peritonitis, malnutrition)
Diarrhoea is also a leading cause of malnutrition in under-5s

Nepal:

In 2017, 1193 under-5 children died from diarrhoea

4. EPIDEMIOLOGICAL DETERMINANTS (Agent, Host, Environment - remember AHE)

A - Agent Factors

Bacterial: E. coli, Shigella, Vibrio cholerae, Salmonella
Viral: Rotavirus (MCC of diarrhoea in children), Adenovirus, Calcivirus
Parasitic: Giardia lamblia

Viva tip: Rotavirus = MCC in children | Shigella = MCC of dysentery

H - Host Factors

Most common in children 6 months - 2 years
Malnutrition → weaker immune system → more susceptible
Lack of exclusive breastfeeding in first 6 months → loses protective antibodies
Zinc deficiency, Vitamin A deficiency, HIV, lack of rotavirus vaccine → increase severity

E - Environmental Factors

Bacterial diarrhoea → more common in warm/rainy season
Viral diarrhoea → more common in winter
Poor sanitation, no handwashing, unsafe water, contaminated food
Crowded living, refugee camps, disasters → outbreak risk

5. RISK FACTORS (Easy list to remember)

Use the mnemonic "Children PAIN CMP":

Children 6 months - 2 years
Poor sanitation & personal hygiene
Absence of safe drinking water
Immunization low rates / Immunodeficiency
No breastfeeding (low breastfeeding rates)
Crowded living conditions
Malnutrition
Poverty + Unsafe food preparation

6. MODE OF TRANSMISSION

Primary route = Faecal-Oral route

3 ways it spreads:

Water-borne (contaminated water)
Food-borne (contaminated food)
Direct transmission (person to person, hand to mouth)

Easy to remember: "Faecal → Oral via Water, Food, or Direct contact"

7. ASSESSMENT OF DEHYDRATION (The most important table!)

Feature	No Dehydration	Some Dehydration	Severe Dehydration
General	Well, alert	Restless, irritable	Lethargic/unconscious
Eyes	Normal	Sunken	Very sunken & dry
Tears	Present	Absent	Absent
Mouth/tongue	Moist	Dry	Very dry
Thirst	Normal, not thirsty	Thirsty, drinks eagerly	Drinks poorly/can't drink
Skin pinch	Goes back quickly	Goes back slowly (<2 sec)	Goes back very slowly (>2 sec)
Decision rule	No signs	≥2 signs = Some	≥2 signs = Severe
Treatment	Plan A	Plan B	Plan C (urgently!)

Viva tip for the case scenario: 8-month-old with sunken eyes + skin pinch >2 sec + drowsy = SEVERE DEHYDRATION → Plan C

8. TREATMENT PLANS (A, B, C)

Plan A - No Dehydration (Treat at home)

WHO ORS at home after every loose stool
- <2 years: 50-100 ml per loose stool
- 2-10 years: 100-200 ml per loose stool
Zinc supplementation
Teach mother danger signs

Plan B - Some Dehydration (Treat at health centre/hospital)

IV Fluids (RL or NS) - Normal daily requirement:
- <10 kg = 100 ml/kg/day
- 10-20 kg = 50 ml/kg/day
- 20 kg = 20 ml/kg/day
WHO ORS: 75 mL/kg in first 4 hours (deficit replacement)
Zinc supplementation
Maintenance fluid (Plan A ORS for ongoing losses)

Plan C - Severe Dehydration (Emergency!)

IV Bolus: 100 ml/kg of RL/NS (with or without 5% dextrose)
WHO ORS if child can drink orally
Zinc supplementation
Reassess every 2-3 hours → if improved: go to Plan B → then Plan A

9. ORS COMPOSITION

WHO ORS contains (per litre):

Sodium chloride: 2.6 g
Glucose anhydrous: 13.5 g
Trisodium citrate: 2.9 g
Potassium chloride: 1.5 g
Osmolarity: ~245 mOsmol/L (low-osmolarity ORS)

Homemade ORS Recipe (for community use):

1 litre clean water + 6 level teaspoons sugar + ½ level teaspoon salt
Should taste like tears (not too salty, not too sweet)
Use within 24 hours

10. ZINC SUPPLEMENTATION (Numbers to remember!)

Age	Dose	Duration
<6 months	10 mg/day	10-14 days
>6 months	20 mg/day	10-14 days

Why zinc? It reduces duration and severity of diarrhoea AND prevents future episodes.

11. CHEMOTHERAPY (Only specific organisms!)

Organism	Drug
Vibrio cholerae	Doxycycline / Tetracycline / Erythromycin / TMP-SMX
Shigella	Ciprofloxacin

Note: Antibiotics are NOT given routinely for all diarrhoea - only for specific causative organisms!

12. PREVENTION & CONTROL (WHO recommended)

Short-term measures (Clinical management):

ORS (Oral rehydration)
IV fluids (RL/NS)
Maintenance ORS
Chemotherapy (when indicated)
Zinc supplementation

Long-term measures:

A) Better MCH Care (Maternal & Child Nutrition):

Promote breastfeeding (reduces diarrhoeal disease)
Appropriate weaning (poor weaning = major risk factor)
Supplementary feeding (improve nutritional status)
Vitamin A supplementation (prevents diarrhoea)
Maternal nutrition

B) Preventive Strategies:

Health Education:
- About diarrhoeal disease
- Environmental sanitation & personal hygiene
- Safe drinking water, use of latrine, proper excreta disposal
Sanitation:
- Personal/domestic hygiene
- Safe water supply
- Clean toilets, proper excreta disposal (especially young children's)
Immunization:
- Measles vaccine (reduces diarrhoea-related deaths)
- Rotavirus vaccine (most direct prevention)
Fly Control:
- Control flies that breed in human/animal faeces

13. ROTAVIRUS VACCINE (likely a specific question!)

Oral vaccine given to infants
2 doses: at 6 weeks and 10 weeks (in Nepal's national immunization schedule)
Protects against the MCC of diarrhoea in children
Part of Nepal's national immunization programme

14. NATIONAL PLANS FOR ADD IN NEPAL

IMCI (Integrated Management of Childhood Illness) - uses Plan A/B/C framework
CSSDP (Control of diarrhoeal disease programme)
Oral Rehydration Corners (ORC) at health facilities
Community-based ORS distribution
Health worker training on dehydration assessment

15. SAMPLE VIVA QUESTION (From your slide - memorize this!)

Q. A 28-year-old man from flood-affected Terai with profuse watery diarrhoea, vomiting, dehydration - several cases in village, contaminated water supply. Five key public health strategies?

Answer (5 points):

Safe drinking water - chlorine tablets, boil water, repair water supply
Sanitation & hygiene - handwashing with soap, safe food handling, proper waste disposal
Disease surveillance - activate Rapid Response Teams (RRTs), monitor cases, report outbreaks
Health education - use media/volunteers/posters, educate on symptoms and when to seek care
Emergency rehydration services - set up ORS corners, ensure ORS/IV fluids/medicines availability

QUICK RECALL SHEET FOR TOMORROW

Topic	Key Number/Fact
Deaths per year in under-5	525,000
Global cases per year	1.7 billion
Deaths in first 2 years	80%
Nepal 2017 under-5 deaths	1193
Main cause of death from diarrhoea	Dehydration
MCC diarrhoea in children	Rotavirus
MCC of dysentery	Shigella
Drug for Shigella	Ciprofloxacin
Drug for Cholera	Doxycycline
Zinc <6 months	10 mg/day × 10-14 days
Zinc >6 months	20 mg/day × 10-14 days
ORS Plan B deficit	75 ml/kg in 4 hours
Plan C bolus IVF	100 ml/kg RL/NS
Severe dehydration skin pinch	>2 seconds
Homemade ORS	1L water + 6 tsp sugar + ½ tsp salt

All the best for your viva tomorrow! You've got this - go through this once before sleeping and once in the morning. The examiners love asking about dehydration assessment, ORS doses, zinc doses, and prevention. Those are your priority areas!

Quick reference pdf of add

Reading File

Running Command

mkdir -p /home/daytona/workspace/add-pdf && ls /home/daytona/workspace/add-pdf/

Writing File

~/add-pdf/generate_pdf.py

from reportlab.lib.pagesizes import A4
from reportlab.lib import colors
from reportlab.lib.styles import getSampleStyleSheet, ParagraphStyle
from reportlab.lib.units import cm, mm
from reportlab.platypus import (
    SimpleDocTemplate, Paragraph, Spacer, Table, TableStyle,
    HRFlowable, KeepTogether
)
from reportlab.lib.enums import TA_CENTER, TA_LEFT, TA_RIGHT
from reportlab.platypus import PageBreak

OUTPUT = "/home/daytona/workspace/add-pdf/ADD_Quick_Reference.pdf"

doc = SimpleDocTemplate(
    OUTPUT,
    pagesize=A4,
    rightMargin=1.5*cm,
    leftMargin=1.5*cm,
    topMargin=1.8*cm,
    bottomMargin=1.5*cm,
)

# ─── Color palette ───────────────────────────────────────────────────────────
NAVY    = colors.HexColor("#1a3a5c")
TEAL    = colors.HexColor("#0e7c7b")
AMBER   = colors.HexColor("#f4a011")
RED     = colors.HexColor("#c0392b")
GREEN   = colors.HexColor("#1e8449")
LBLUE   = colors.HexColor("#d6eaf8")
LYELLOW = colors.HexColor("#fef9e7")
LGREEN  = colors.HexColor("#eafaf1")
LPINK   = colors.HexColor("#fdf2f8")
LRED    = colors.HexColor("#fdedec")
WHITE   = colors.white
LGRAY   = colors.HexColor("#f5f6fa")
GRAY    = colors.HexColor("#7f8c8d")
DGRAY   = colors.HexColor("#2c3e50")

# ─── Styles ──────────────────────────────────────────────────────────────────
styles = getSampleStyleSheet()

def S(name, **kw):
    return ParagraphStyle(name, **kw)

title_style = S("Title2",
    fontSize=20, fontName="Helvetica-Bold",
    textColor=WHITE, alignment=TA_CENTER, spaceAfter=2)

subtitle_style = S("Sub2",
    fontSize=9, fontName="Helvetica",
    textColor=colors.HexColor("#cce8ff"), alignment=TA_CENTER, spaceAfter=0)

section_style = S("Section",
    fontSize=10.5, fontName="Helvetica-Bold",
    textColor=WHITE, alignment=TA_LEFT, spaceAfter=0,
    spaceBefore=0, leftIndent=6)

body_style = S("Body2",
    fontSize=8.5, fontName="Helvetica",
    textColor=DGRAY, leading=13, spaceAfter=1)

bold_body = S("BoldBody",
    fontSize=8.5, fontName="Helvetica-Bold",
    textColor=DGRAY, leading=13)

small_style = S("Small",
    fontSize=7.5, fontName="Helvetica",
    textColor=DGRAY, leading=11)

small_bold = S("SmallBold",
    fontSize=7.5, fontName="Helvetica-Bold",
    textColor=DGRAY, leading=11)

tip_style = S("Tip",
    fontSize=8, fontName="Helvetica-BoldOblique",
    textColor=RED, leading=11, leftIndent=4)

cell_style = S("Cell",
    fontSize=8, fontName="Helvetica",
    textColor=DGRAY, leading=11)

cell_bold = S("CellBold",
    fontSize=8, fontName="Helvetica-Bold",
    textColor=DGRAY, leading=11)

hdr_cell = S("HdrCell",
    fontSize=8, fontName="Helvetica-Bold",
    textColor=WHITE, leading=11, alignment=TA_CENTER)

# ─── Helpers ─────────────────────────────────────────────────────────────────
def section_header(text, bg=NAVY):
    data = [[Paragraph(text, section_style)]]
    t = Table(data, colWidths=[17.7*cm])
    t.setStyle(TableStyle([
        ("BACKGROUND", (0,0), (-1,-1), bg),
        ("TOPPADDING",    (0,0), (-1,-1), 5),
        ("BOTTOMPADDING", (0,0), (-1,-1), 5),
        ("LEFTPADDING",   (0,0), (-1,-1), 8),
        ("RIGHTPADDING",  (0,0), (-1,-1), 8),
        ("ROUNDEDCORNERS", [4]),
    ]))
    return t

def tip_box(text):
    data = [[Paragraph(f"⚑  {text}", tip_style)]]
    t = Table(data, colWidths=[17.7*cm])
    t.setStyle(TableStyle([
        ("BACKGROUND",    (0,0), (-1,-1), LRED),
        ("TOPPADDING",    (0,0), (-1,-1), 4),
        ("BOTTOMPADDING", (0,0), (-1,-1), 4),
        ("LEFTPADDING",   (0,0), (-1,-1), 8),
        ("RIGHTPADDING",  (0,0), (-1,-1), 8),
        ("LINEBELOW",     (0,0), (-1,-1), 0.5, RED),
    ]))
    return t

def info_box(text, bg=LBLUE):
    data = [[Paragraph(text, body_style)]]
    t = Table(data, colWidths=[17.7*cm])
    t.setStyle(TableStyle([
        ("BACKGROUND",    (0,0), (-1,-1), bg),
        ("TOPPADDING",    (0,0), (-1,-1), 5),
        ("BOTTOMPADDING", (0,0), (-1,-1), 5),
        ("LEFTPADDING",   (0,0), (-1,-1), 10),
        ("RIGHTPADDING",  (0,0), (-1,-1), 10),
    ]))
    return t

def sp(h=4):
    return Spacer(1, h)

# ─── Build story ─────────────────────────────────────────────────────────────
story = []

# ═══════════════ TITLE BANNER ════════════════════════════════════════════════
title_data = [
    [Paragraph("ACUTE DIARRHOEAL DISEASES (ADD)", title_style)],
    [Paragraph("PSM Viva Quick Reference  •  Dr. Narendra Kumar Yadav", subtitle_style)],
]
title_table = Table(title_data, colWidths=[17.7*cm])
title_table.setStyle(TableStyle([
    ("BACKGROUND",    (0,0), (-1,-1), NAVY),
    ("TOPPADDING",    (0,0), (0,0),  10),
    ("BOTTOMPADDING", (0,-1),(-1,-1),10),
    ("LEFTPADDING",   (0,0), (-1,-1), 0),
    ("RIGHTPADDING",  (0,0), (-1,-1), 0),
]))
story.append(title_table)
story.append(sp(8))

# ═══════════════ TWO-COLUMN LAYOUT: top section ══════════════════════════════
# Left col: Definition + Classification | Right col: Epidemiology numbers

# --- DEFINITION ---
def_block = [
    section_header("1. DEFINITION", NAVY),
    sp(3),
    info_box("<b>Diarrhoea</b> = Change in <b>consistency</b> (watery/loose stool) <b>AND frequency</b> (&gt;3 times/day)", LBLUE),
    sp(3),
]

# --- CLASSIFICATION ---
def_block.append(section_header("2. CLINICAL TYPES", TEAL))
def_block.append(sp(3))
class_data = [
    [Paragraph("Type", hdr_cell), Paragraph("Duration", hdr_cell), Paragraph("Key Point", hdr_cell)],
    [Paragraph("Acute watery diarrhoea", cell_bold), Paragraph("< 4 weeks", cell_style), Paragraph("Watery loose stool", cell_style)],
    [Paragraph("Acute bloody (Dysentery)", cell_bold), Paragraph("< 4 weeks", cell_style), Paragraph("Blood/mucus in stool", cell_style)],
    [Paragraph("Persistent diarrhoea", cell_bold), Paragraph("> 14 days", cell_style), Paragraph("Between acute & chronic", cell_style)],
    [Paragraph("Chronic diarrhoea", cell_bold), Paragraph("> 4 weeks", cell_style), Paragraph("Long-standing", cell_style)],
    [Paragraph("With malnutrition", cell_bold), Paragraph("-", cell_style), Paragraph("Marasmus / Kwashiorkor", cell_style)],
]
class_table = Table(class_data, colWidths=[5.5*cm, 3*cm, 5.5*cm], spaceBefore=0)
class_table.setStyle(TableStyle([
    ("BACKGROUND",    (0,0), (-1,0), TEAL),
    ("BACKGROUND",    (0,1), (-1,1), LGREEN),
    ("BACKGROUND",    (0,2), (-1,2), WHITE),
    ("BACKGROUND",    (0,3), (-1,3), LGREEN),
    ("BACKGROUND",    (0,4), (-1,4), WHITE),
    ("BACKGROUND",    (0,5), (-1,5), LGREEN),
    ("GRID",          (0,0), (-1,-1), 0.4, colors.HexColor("#bdc3c7")),
    ("TOPPADDING",    (0,0), (-1,-1), 4),
    ("BOTTOMPADDING", (0,0), (-1,-1), 4),
    ("LEFTPADDING",   (0,0), (-1,-1), 5),
    ("RIGHTPADDING",  (0,0), (-1,-1), 5),
    ("VALIGN",        (0,0), (-1,-1), "MIDDLE"),
]))
def_block.append(class_table)
def_block.append(sp(3))
def_block.append(tip_box("MCC of Dysentery = Shigella | MCC of Diarrhoea in children = Rotavirus"))

# ═══════════════ EPIDEMIOLOGY ════════════════════════════════════════════════
story.append(KeepTogether(def_block))
story.append(sp(6))

story.append(section_header("3. EPIDEMIOLOGY (WHO)", NAVY))
story.append(sp(3))

epi_data = [
    [Paragraph("Indicator", hdr_cell), Paragraph("Figure", hdr_cell)],
    [Paragraph("Rank among causes of under-5 deaths", cell_style), Paragraph("<b>2nd leading cause</b>", cell_bold)],
    [Paragraph("Global childhood diarrhoea cases/year", cell_style), Paragraph("<b>1.7 billion</b>", cell_bold)],
    [Paragraph("Under-5 deaths per year", cell_style), Paragraph("<b>525,000</b>", cell_bold)],
    [Paragraph("Deaths in first 2 years of life", cell_style), Paragraph("<b>80%</b>", cell_bold)],
    [Paragraph("Main cause of death from diarrhoea", cell_style), Paragraph("<b>Dehydration</b>", cell_bold)],
    [Paragraph("Nepal under-5 deaths (2017)", cell_style), Paragraph("<b>1,193 children</b>", cell_bold)],
]
epi_table = Table(epi_data, colWidths=[10*cm, 7.7*cm])
epi_table.setStyle(TableStyle([
    ("BACKGROUND",    (0,0), (-1,0), NAVY),
    ("BACKGROUND",    (0,1), (-1,1), LYELLOW),
    ("BACKGROUND",    (0,2), (-1,2), WHITE),
    ("BACKGROUND",    (0,3), (-1,3), LYELLOW),
    ("BACKGROUND",    (0,4), (-1,4), WHITE),
    ("BACKGROUND",    (0,5), (-1,5), LYELLOW),
    ("BACKGROUND",    (0,6), (-1,6), WHITE),
    ("GRID",          (0,0), (-1,-1), 0.4, colors.HexColor("#bdc3c7")),
    ("TOPPADDING",    (0,0), (-1,-1), 4),
    ("BOTTOMPADDING", (0,0), (-1,-1), 4),
    ("LEFTPADDING",   (0,0), (-1,-1), 6),
    ("RIGHTPADDING",  (0,0), (-1,-1), 6),
    ("VALIGN",        (0,0), (-1,-1), "MIDDLE"),
]))
story.append(epi_table)
story.append(sp(6))

# ═══════════════ EPIDEMIOLOGICAL DETERMINANTS ════════════════════════════════
story.append(section_header("4. EPIDEMIOLOGICAL DETERMINANTS (Agent - Host - Environment)", TEAL))
story.append(sp(3))

det_data = [
    [Paragraph("AGENT", hdr_cell), Paragraph("HOST", hdr_cell), Paragraph("ENVIRONMENT", hdr_cell)],
    [
        Paragraph("<b>Bacterial:</b> E. coli, Shigella, V. cholerae, Salmonella<br/><br/>"
                  "<b>Viral:</b> Rotavirus (MCC in children), Adenovirus, Calcivirus<br/><br/>"
                  "<b>Parasitic:</b> Giardia lamblia", cell_style),
        Paragraph("<b>Age:</b> 6 months – 2 years (most at risk)<br/><br/>"
                  "<b>Malnutrition</b> → weaker immunity<br/><br/>"
                  "<b>No exclusive breastfeeding</b> in first 6 months<br/><br/>"
                  "<b>Zinc/Vit A deficiency, HIV,</b> no rotavirus vaccine", cell_style),
        Paragraph("<b>Bacterial diarrhoea:</b> warm/rainy season<br/><br/>"
                  "<b>Viral diarrhoea:</b> winter season<br/><br/>"
                  "Poor sanitation, unsafe water, contaminated food<br/><br/>"
                  "Crowded living, refugee camps, disasters", cell_style),
    ],
]
det_table = Table(det_data, colWidths=[5.9*cm, 5.9*cm, 5.9*cm])
det_table.setStyle(TableStyle([
    ("BACKGROUND",    (0,0), (-1,0), TEAL),
    ("BACKGROUND",    (0,1), (0,1), LGREEN),
    ("BACKGROUND",    (1,1), (1,1), LYELLOW),
    ("BACKGROUND",    (2,1), (2,1), LRED),
    ("GRID",          (0,0), (-1,-1), 0.4, colors.HexColor("#bdc3c7")),
    ("TOPPADDING",    (0,0), (-1,-1), 5),
    ("BOTTOMPADDING", (0,0), (-1,-1), 5),
    ("LEFTPADDING",   (0,0), (-1,-1), 5),
    ("RIGHTPADDING",  (0,0), (-1,-1), 5),
    ("VALIGN",        (0,0), (-1,-1), "TOP"),
]))
story.append(det_table)
story.append(sp(6))

# ═══════════════ RISK FACTORS + TRANSMISSION (side by side) ══════════════════
rf_block = [
    section_header("5. RISK FACTORS", NAVY),
    sp(3),
    Paragraph("• Children 6 months – 2 years", body_style),
    Paragraph("• Poor sanitation &amp; personal hygiene", body_style),
    Paragraph("• No safe drinking water", body_style),
    Paragraph("• Unsafe food preparation", body_style),
    Paragraph("• Low breastfeeding / immunization rates", body_style),
    Paragraph("• Immunodeficiency", body_style),
    Paragraph("• Malnutrition", body_style),
    Paragraph("• Crowded living conditions", body_style),
    Paragraph("• Poverty", body_style),
]

tx_block = [
    section_header("6. MODE OF TRANSMISSION", TEAL),
    sp(3),
    info_box("<b>Primary route = Faecal-Oral Route</b>", LBLUE),
    sp(4),
    Paragraph("<b>a. Water-borne</b> – contaminated water supply", body_style),
    Paragraph("<b>b. Food-borne</b> – contaminated/undercooked food", body_style),
    Paragraph("<b>c. Direct transmission</b> – person to person, hand to mouth", body_style),
    sp(4),
    tip_box("Remember: F-O-R  →  Faecal → Oral via Water / Food / Direct"),
]

left_col  = [[item] for item in rf_block]
right_col = [[item] for item in tx_block]

# Render as two-column table
combined = Table(
    [[rf_block, tx_block]],
    colWidths=[8.6*cm, 9.1*cm],
    spaceBefore=0
)
combined.setStyle(TableStyle([
    ("VALIGN",       (0,0), (-1,-1), "TOP"),
    ("LEFTPADDING",  (0,0), (-1,-1), 0),
    ("RIGHTPADDING", (0,0), (-1,-1), 0),
    ("TOPPADDING",   (0,0), (-1,-1), 0),
    ("BOTTOMPADDING",(0,0), (-1,-1), 0),
    ("INNERGRID",    (0,0), (-1,-1), 0, WHITE),
]))
story.append(combined)
story.append(sp(6))

# ═══════════════ DEHYDRATION ASSESSMENT TABLE ═════════════════════════════════
story.append(section_header("7. ASSESSMENT OF DEHYDRATION", RED))
story.append(sp(3))

deh_data = [
    [Paragraph("Feature", hdr_cell), Paragraph("No Dehydration", hdr_cell),
     Paragraph("Some Dehydration", hdr_cell), Paragraph("Severe Dehydration", hdr_cell)],
    [Paragraph("General condition", cell_bold), Paragraph("Well, alert", cell_style),
     Paragraph("Restless, irritable", cell_style), Paragraph("Lethargic / unconscious", cell_style)],
    [Paragraph("Eyes", cell_bold), Paragraph("Normal", cell_style),
     Paragraph("Sunken", cell_style), Paragraph("Very sunken &amp; dry", cell_style)],
    [Paragraph("Tears", cell_bold), Paragraph("Present", cell_style),
     Paragraph("Absent", cell_style), Paragraph("Absent", cell_style)],
    [Paragraph("Mouth / tongue", cell_bold), Paragraph("Moist", cell_style),
     Paragraph("Dry", cell_style), Paragraph("Very dry", cell_style)],
    [Paragraph("Thirst", cell_bold), Paragraph("Normal, not thirsty", cell_style),
     Paragraph("Thirsty, drinks eagerly", cell_style), Paragraph("Drinks poorly / can't drink", cell_style)],
    [Paragraph("Skin pinch", cell_bold), Paragraph("Goes back quickly", cell_style),
     Paragraph("Slowly (&lt;2 sec)", cell_style), Paragraph("Very slowly (&gt;2 sec)", cell_style)],
    [Paragraph("Decision", cell_bold), Paragraph("No dehydration", cell_style),
     Paragraph("≥2 signs = SOME", cell_bold), Paragraph("≥2 signs = SEVERE", cell_bold)],
    [Paragraph("TREATMENT", cell_bold),
     Paragraph("PLAN A", ParagraphStyle("PlanA", fontSize=8, fontName="Helvetica-Bold", textColor=GREEN, leading=11)),
     Paragraph("PLAN B", ParagraphStyle("PlanB", fontSize=8, fontName="Helvetica-Bold", textColor=colors.HexColor("#e67e22"), leading=11)),
     Paragraph("PLAN C (URGENT)", ParagraphStyle("PlanC", fontSize=8, fontName="Helvetica-Bold", textColor=RED, leading=11))],
]

deh_table = Table(deh_data, colWidths=[3.5*cm, 4.3*cm, 4.5*cm, 5.4*cm])
deh_table.setStyle(TableStyle([
    ("BACKGROUND",    (0,0),  (-1,0),  RED),
    ("BACKGROUND",    (1,1),  (1,-1),  LGREEN),
    ("BACKGROUND",    (2,1),  (2,-1),  LYELLOW),
    ("BACKGROUND",    (3,1),  (3,-1),  LRED),
    ("BACKGROUND",    (0,1),  (0,-1),  LGRAY),
    ("BACKGROUND",    (0,-1), (-1,-1), colors.HexColor("#e8f8f5")),
    ("GRID",          (0,0),  (-1,-1), 0.4, colors.HexColor("#bdc3c7")),
    ("TOPPADDING",    (0,0),  (-1,-1), 4),
    ("BOTTOMPADDING", (0,0),  (-1,-1), 4),
    ("LEFTPADDING",   (0,0),  (-1,-1), 5),
    ("RIGHTPADDING",  (0,0),  (-1,-1), 5),
    ("VALIGN",        (0,0),  (-1,-1), "MIDDLE"),
]))
story.append(deh_table)
story.append(sp(3))
story.append(tip_box("Case: 8-month-old — drowsy + sunken eyes + skin pinch >2 sec = SEVERE DEHYDRATION → PLAN C"))
story.append(sp(8))

# ═══════════════ TREATMENT PLANS ══════════════════════════════════════════════
story.append(section_header("8. TREATMENT PLANS", GREEN))
story.append(sp(3))

plan_a = [
    Paragraph("<b>PLAN A — No Dehydration (Home)</b>", ParagraphStyle("PA", fontSize=9, fontName="Helvetica-Bold", textColor=GREEN, leading=13)),
    sp(2),
    Paragraph("• WHO ORS after every loose stool:", body_style),
    Paragraph("  &nbsp;&nbsp;– &lt;2 years: <b>50–100 ml</b>/loose stool", body_style),
    Paragraph("  &nbsp;&nbsp;– 2–10 years: <b>100–200 ml</b>/loose stool", body_style),
    Paragraph("• Zinc supplementation", body_style),
    Paragraph("• Teach mother danger signs", body_style),
]

plan_b = [
    Paragraph("<b>PLAN B — Some Dehydration (Hospital)</b>", ParagraphStyle("PB", fontSize=9, fontName="Helvetica-Bold", textColor=colors.HexColor("#e67e22"), leading=13)),
    sp(2),
    Paragraph("1. IV fluids (RL/NS):", body_style),
    Paragraph("   &lt;10 kg = <b>100 ml/kg/day</b>", body_style),
    Paragraph("   10–20 kg = <b>50 ml/kg/day</b>", body_style),
    Paragraph("   &gt;20 kg = <b>20 ml/kg/day</b>", body_style),
    Paragraph("2. WHO ORS: <b>75 ml/kg</b> in first 4 hours", body_style),
    Paragraph("3. Zinc supplementation", body_style),
    Paragraph("4. Maintenance ORS (Plan A)", body_style),
]

plan_c = [
    Paragraph("<b>PLAN C — Severe Dehydration (EMERGENCY)</b>", ParagraphStyle("PC", fontSize=9, fontName="Helvetica-Bold", textColor=RED, leading=13)),
    sp(2),
    Paragraph("1. IV Bolus: <b>100 ml/kg</b> RL/NS (±5% dextrose)", body_style),
    Paragraph("2. WHO ORS if child can drink orally", body_style),
    Paragraph("3. Zinc supplementation", body_style),
    Paragraph("4. Reassess every <b>2–3 hrs</b>", body_style),
    Paragraph("   If improved → Plan B → Plan A", body_style),
]

plans_table = Table(
    [[plan_a, plan_b, plan_c]],
    colWidths=[5.5*cm, 6*cm, 6.2*cm]
)
plans_table.setStyle(TableStyle([
    ("VALIGN",        (0,0), (-1,-1), "TOP"),
    ("LEFTPADDING",   (0,0), (-1,-1), 6),
    ("RIGHTPADDING",  (0,0), (-1,-1), 6),
    ("TOPPADDING",    (0,0), (-1,-1), 6),
    ("BOTTOMPADDING", (0,0), (-1,-1), 6),
    ("BACKGROUND",    (0,0), (0,0),   LGREEN),
    ("BACKGROUND",    (1,0), (1,0),   LYELLOW),
    ("BACKGROUND",    (2,0), (2,0),   LRED),
    ("BOX",           (0,0), (0,0),   0.8, GREEN),
    ("BOX",           (1,0), (1,0),   0.8, colors.HexColor("#e67e22")),
    ("BOX",           (2,0), (2,0),   0.8, RED),
]))
story.append(plans_table)
story.append(sp(6))

# ═══════════════ ORS + ZINC + CHEMOTHERAPY ═══════════════════════════════════
ors_block = [
    section_header("9. ORS COMPOSITION (WHO)", TEAL),
    sp(3),
    info_box("<b>WHO Low-Osmolarity ORS</b> (per litre):<br/>"
             "Sodium chloride: <b>2.6 g</b> | Glucose anhydrous: <b>13.5 g</b><br/>"
             "Trisodium citrate: <b>2.9 g</b> | Potassium chloride: <b>1.5 g</b><br/>"
             "Osmolarity: <b>~245 mOsmol/L</b>", LBLUE),
    sp(4),
    section_header("HOMEMADE ORS", colors.HexColor("#5d6d7e")),
    sp(3),
    info_box("1 litre clean water + <b>6 level tsp sugar</b> + <b>½ tsp salt</b><br/>"
             "Tastes like tears (not too salty, not too sweet)<br/>"
             "Use within <b>24 hours</b>", LGRAY),
]

zinc_chemo_block = [
    section_header("10. ZINC SUPPLEMENTATION", AMBER),
    sp(3),
]
zinc_data = [
    [Paragraph("Age", hdr_cell), Paragraph("Dose", hdr_cell), Paragraph("Duration", hdr_cell)],
    [Paragraph("&lt; 6 months", cell_style), Paragraph("<b>10 mg/day</b>", cell_bold), Paragraph("10–14 days", cell_style)],
    [Paragraph("&gt; 6 months", cell_style), Paragraph("<b>20 mg/day</b>", cell_bold), Paragraph("10–14 days", cell_style)],
]
zinc_table = Table(zinc_data, colWidths=[2.8*cm, 3*cm, 2.8*cm])
zinc_table.setStyle(TableStyle([
    ("BACKGROUND",    (0,0), (-1,0),   AMBER),
    ("BACKGROUND",    (0,1), (-1,1),   LYELLOW),
    ("BACKGROUND",    (0,2), (-1,2),   WHITE),
    ("GRID",          (0,0), (-1,-1),  0.4, colors.HexColor("#bdc3c7")),
    ("TOPPADDING",    (0,0), (-1,-1),  4),
    ("BOTTOMPADDING", (0,0), (-1,-1),  4),
    ("LEFTPADDING",   (0,0), (-1,-1),  5),
    ("RIGHTPADDING",  (0,0), (-1,-1),  5),
    ("VALIGN",        (0,0), (-1,-1),  "MIDDLE"),
]))
zinc_chemo_block.append(zinc_table)
zinc_chemo_block.append(sp(5))
zinc_chemo_block.append(section_header("11. CHEMOTHERAPY", RED))
zinc_chemo_block.append(sp(3))

chemo_data = [
    [Paragraph("Organism", hdr_cell), Paragraph("Drug of Choice", hdr_cell)],
    [Paragraph("Vibrio cholerae", cell_bold), Paragraph("Doxycycline / Tetracycline / Erythromycin / TMP-SMX", cell_style)],
    [Paragraph("Shigella", cell_bold), Paragraph("Ciprofloxacin", cell_style)],
]
chemo_table = Table(chemo_data, colWidths=[3.5*cm, 5.1*cm])
chemo_table.setStyle(TableStyle([
    ("BACKGROUND",    (0,0), (-1,0),  RED),
    ("BACKGROUND",    (0,1), (-1,1),  LRED),
    ("BACKGROUND",    (0,2), (-1,2),  WHITE),
    ("GRID",          (0,0), (-1,-1), 0.4, colors.HexColor("#bdc3c7")),
    ("TOPPADDING",    (0,0), (-1,-1), 4),
    ("BOTTOMPADDING", (0,0), (-1,-1), 4),
    ("LEFTPADDING",   (0,0), (-1,-1), 5),
    ("RIGHTPADDING",  (0,0), (-1,-1), 5),
    ("VALIGN",        (0,0), (-1,-1), "MIDDLE"),
]))
zinc_chemo_block.append(chemo_table)
zinc_chemo_block.append(sp(3))
zinc_chemo_block.append(tip_box("Antibiotics only for specific organisms — NOT routine!"))

two_col = Table(
    [[ors_block, zinc_chemo_block]],
    colWidths=[8.5*cm, 9.2*cm]
)
two_col.setStyle(TableStyle([
    ("VALIGN",        (0,0), (-1,-1), "TOP"),
    ("LEFTPADDING",   (0,0), (-1,-1), 0),
    ("RIGHTPADDING",  (0,0), (-1,-1), 0),
    ("TOPPADDING",    (0,0), (-1,-1), 0),
    ("BOTTOMPADDING", (0,0), (-1,-1), 0),
]))
story.append(two_col)
story.append(sp(6))

# ═══════════════ PREVENTION & CONTROL ════════════════════════════════════════
story.append(section_header("12. PREVENTION & CONTROL (WHO Recommendations)", NAVY))
story.append(sp(3))

prev_data = [
    [Paragraph("SHORT-TERM (Clinical)", hdr_cell), Paragraph("LONG-TERM (A): MCH Care", hdr_cell), Paragraph("LONG-TERM (B): Preventive Strategies", hdr_cell)],
    [
        Paragraph("• ORS (oral rehydration)<br/>• IV fluids (RL/NS)<br/>• Maintenance ORS<br/>• Chemotherapy (when indicated)<br/>• Zinc supplementation", cell_style),
        Paragraph("1. Promote <b>breastfeeding</b><br/>2. Appropriate <b>weaning</b> practices<br/>3. <b>Supplementary feeding</b><br/>4. <b>Vitamin A</b> supplementation<br/>5. Maternal nutrition", cell_style),
        Paragraph("<b>Health Education:</b> sanitation, hygiene, safe water, latrine use<br/>"
                  "<b>Sanitation:</b> clean toilets, safe water, excreta disposal<br/>"
                  "<b>Immunization:</b> Measles vaccine + <b>Rotavirus vaccine</b><br/>"
                  "<b>Fly control:</b> control flies near faeces", cell_style),
    ],
]
prev_table = Table(prev_data, colWidths=[4.5*cm, 5.5*cm, 7.7*cm])
prev_table.setStyle(TableStyle([
    ("BACKGROUND",    (0,0), (-1,0), NAVY),
    ("BACKGROUND",    (0,1), (0,1), LGREEN),
    ("BACKGROUND",    (1,1), (1,1), LYELLOW),
    ("BACKGROUND",    (2,1), (2,1), LPINK),
    ("GRID",          (0,0), (-1,-1), 0.4, colors.HexColor("#bdc3c7")),
    ("TOPPADDING",    (0,0), (-1,-1), 5),
    ("BOTTOMPADDING", (0,0), (-1,-1), 5),
    ("LEFTPADDING",   (0,0), (-1,-1), 5),
    ("RIGHTPADDING",  (0,0), (-1,-1), 5),
    ("VALIGN",        (0,0), (-1,-1), "TOP"),
]))
story.append(prev_table)
story.append(sp(6))

# ═══════════════ QUICK RECALL NUMBERS ════════════════════════════════════════
story.append(section_header("QUICK RECALL — KEY NUMBERS FOR VIVA", AMBER))
story.append(sp(3))

recall_items = [
    ("Under-5 deaths/year globally", "525,000"),
    ("Global cases/year", "1.7 billion"),
    ("Deaths in first 2 years", "80%"),
    ("Nepal under-5 deaths (2017)", "1,193"),
    ("MCC diarrhoea in children", "Rotavirus"),
    ("MCC of dysentery", "Shigella"),
    ("Drug for Shigella", "Ciprofloxacin"),
    ("Drug for Cholera", "Doxycycline"),
    ("Zinc <6 months", "10 mg/day × 10–14 days"),
    ("Zinc >6 months", "20 mg/day × 10–14 days"),
    ("Plan B ORS deficit", "75 ml/kg in 4 hours"),
    ("Plan C IV bolus", "100 ml/kg RL/NS"),
    ("Skin pinch — severe dehyd.", "> 2 seconds"),
    ("Homemade ORS", "1L water + 6 tsp sugar + ½ tsp salt"),
]

# Split into 2 columns of 7
col1 = recall_items[:7]
col2 = recall_items[7:]

def recall_mini_table(items):
    rows = [[Paragraph(k, small_style), Paragraph(v, small_bold)] for k, v in items]
    t = Table(rows, colWidths=[4.5*cm, 3.8*cm])
    style = [
        ("TOPPADDING",    (0,0), (-1,-1), 3),
        ("BOTTOMPADDING", (0,0), (-1,-1), 3),
        ("LEFTPADDING",   (0,0), (-1,-1), 5),
        ("RIGHTPADDING",  (0,0), (-1,-1), 5),
        ("VALIGN",        (0,0), (-1,-1), "MIDDLE"),
        ("LINEBELOW",     (0,0), (-1,-2), 0.3, colors.HexColor("#f0d080")),
    ]
    for i in range(0, len(rows), 2):
        style.append(("BACKGROUND", (0,i), (-1,i), LYELLOW))
        if i+1 < len(rows):
            style.append(("BACKGROUND", (0,i+1), (-1,i+1), WHITE))
    t.setStyle(TableStyle(style))
    return t

recall_table = Table(
    [[recall_mini_table(col1), recall_mini_table(col2)]],
    colWidths=[8.6*cm, 9.1*cm]
)
recall_table.setStyle(TableStyle([
    ("VALIGN",        (0,0), (-1,-1), "TOP"),
    ("LEFTPADDING",   (0,0), (-1,-1), 0),
    ("RIGHTPADDING",  (0,0), (-1,-1), 0),
    ("TOPPADDING",    (0,0), (-1,-1), 0),
    ("BOTTOMPADDING", (0,0), (-1,-1), 0),
]))
story.append(recall_table)
story.append(sp(6))

# ═══════════════ VIVA QUESTION ════════════════════════════════════════════════
story.append(section_header("SAMPLE VIVA QUESTION & ANSWER", RED))
story.append(sp(3))
story.append(info_box(
    "<b>Q. A 28-year-old man from flood-affected Terai presents with profuse watery diarrhoea, "
    "vomiting, dehydration. Water supply contaminated. Several similar cases in the village. "
    "Name five public health strategies to prevent spread.</b>", LPINK))
story.append(sp(4))

ans_data = [
    [Paragraph("Strategy", hdr_cell), Paragraph("Action", hdr_cell)],
    [Paragraph("1. Safe drinking water", cell_bold),
     Paragraph("Chlorine tablets, boil water, repair water supply systems", cell_style)],
    [Paragraph("2. Sanitation &amp; hygiene", cell_bold),
     Paragraph("Handwashing with soap, safe food handling, proper waste disposal", cell_style)],
    [Paragraph("3. Disease surveillance", cell_bold),
     Paragraph("Activate Rapid Response Teams (RRTs), monitor cases, report outbreaks", cell_style)],
    [Paragraph("4. Health education", cell_bold),
     Paragraph("Media, volunteers, posters — educate on symptoms, prevention, when to seek care", cell_style)],
    [Paragraph("5. Emergency rehydration services", cell_bold),
     Paragraph("Set up ORS corners, ensure ORS/IV fluids/medicines at health posts", cell_style)],
]
ans_table = Table(ans_data, colWidths=[4.5*cm, 13.2*cm])
ans_table.setStyle(TableStyle([
    ("BACKGROUND",    (0,0), (-1,0),   RED),
    ("BACKGROUND",    (0,1), (-1,1),   LRED),
    ("BACKGROUND",    (0,2), (-1,2),   WHITE),
    ("BACKGROUND",    (0,3), (-1,3),   LRED),
    ("BACKGROUND",    (0,4), (-1,4),   WHITE),
    ("BACKGROUND",    (0,5), (-1,5),   LRED),
    ("GRID",          (0,0), (-1,-1),  0.4, colors.HexColor("#bdc3c7")),
    ("TOPPADDING",    (0,0), (-1,-1),  5),
    ("BOTTOMPADDING", (0,0), (-1,-1),  5),
    ("LEFTPADDING",   (0,0), (-1,-1),  6),
    ("RIGHTPADDING",  (0,0), (-1,-1),  6),
    ("VALIGN",        (0,0), (-1,-1),  "MIDDLE"),
]))
story.append(ans_table)
story.append(sp(8))

# ═══════════════ FOOTER ══════════════════════════════════════════════════════
footer_data = [[
    Paragraph("ADD Quick Reference  •  PSM Viva 2026  •  Based on lecture slides by Dr. Narendra Kumar Yadav",
              ParagraphStyle("Footer", fontSize=7, fontName="Helvetica",
                             textColor=WHITE, alignment=TA_CENTER))
]]
footer_table = Table(footer_data, colWidths=[17.7*cm])
footer_table.setStyle(TableStyle([
    ("BACKGROUND",    (0,0), (-1,-1), NAVY),
    ("TOPPADDING",    (0,0), (-1,-1), 5),
    ("BOTTOMPADDING", (0,0), (-1,-1), 5),
]))
story.append(footer_table)

# ─── Build ────────────────────────────────────────────────────────────────────
doc.build(story)
print(f"PDF saved to: {OUTPUT}")

Running Command

cd /home/daytona/workspace/add-pdf && python3 generate_pdf.py 2>&1

Running Command

ls -lh /home/daytona/workspace/add-pdf/ADD_Quick_Reference.pdf

Your quick reference PDF is ready!

ADD Quick Reference

PDF Document · PDF

Here's what's packed into it:

Color-coded sections - each topic has its own color so your eye jumps straight to it
Dehydration table - the full Plan A / B / C comparison table in red/yellow/green
Treatment Plans side by side - all three plans at a glance with exact doses
Agent-Host-Environment determinants in a 3-column table
ORS composition + homemade recipe
Zinc doses and chemotherapy drugs in clean tables
Prevention & control - short-term and long-term measures from WHO
Quick recall numbers box - all the stats you need (525,000, 1.7 billion, 75 ml/kg, etc.)
Sample viva Q&A - the flood scenario with the 5-point answer

Print it out, stick it on your desk tonight. Good luck tomorrow!

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