"""
Comprehensive script to replace all clinical content in the stroke case presentation.
Changes content from Lumbar Spondylosis (21-year-old) to Post-Stroke Hemiplegia (56-year-old).
Only replaces TEXT content - preserves all XML structure, fonts, colors, positions.
"""

from pptx import Presentation
from pptx.util import Pt
from copy import deepcopy
from lxml import etree
import copy

PPTX_PATH = "/tmp/workspace/stroke-case/template.pptx"
OUTPUT_PATH = "/tmp/workspace/stroke-case/stroke_case_output.pptx"

prs = Presentation(PPTX_PATH)

# ─────────────────────────────────────────────────────────────────────────────
# Helper functions
# ─────────────────────────────────────────────────────────────────────────────

def set_paragraph_text(para, new_text):
    """Replace all text in a paragraph's runs with new_text, preserving run formatting.
    Uses the first run for the text; clears all other runs."""
    runs = para.runs
    if not runs:
        # Add a run if none exist
        from pptx.oxml.ns import qn
        r_elem = para._p.makeelement(qn('a:r'), {})
        t_elem = r_elem.makeelement(qn('a:t'), {})
        t_elem.text = new_text
        r_elem.append(t_elem)
        para._p.append(r_elem)
        return
    # Set first run text
    runs[0].text = new_text
    # Clear all other runs
    for run in runs[1:]:
        run.text = ""

def replace_shape_text(shape, new_text_lines):
    """
    Replace text in a text frame paragraph by paragraph.
    new_text_lines: list of strings, one per paragraph.
    Only replaces paragraphs that have text; preserves empty spacer paragraphs.
    """
    tf = shape.text_frame
    paras = tf.paragraphs
    text_para_indices = [i for i, p in enumerate(paras) if p.text.strip()]
    
    for idx, new_text in enumerate(new_text_lines):
        if idx < len(text_para_indices):
            para = paras[text_para_indices[idx]]
            set_paragraph_text(para, new_text)

def replace_all_runs_in_shape(shape, new_text):
    """Replace all text in a shape by setting the first run of the first paragraph 
    and clearing everything else. Good for single-block text shapes."""
    tf = shape.text_frame
    first_set = False
    for para in tf.paragraphs:
        for run in para.runs:
            if not first_set:
                run.text = new_text
                first_set = True
            else:
                run.text = ""

def get_shape_by_name(slide, name):
    for shape in slide.shapes:
        if shape.name == name:
            return shape
    return None

def get_text_shapes(slide):
    """Return all shapes with text frames."""
    return [s for s in slide.shapes if s.has_text_frame and s.text_frame.text.strip()]

def get_table_shapes(slide):
    """Return all shapes with tables."""
    return [s for s in slide.shapes if s.has_table]

def set_cell_text(cell, new_text):
    """Replace all text in a table cell."""
    tf = cell.text_frame
    paras = tf.paragraphs
    first_set = False
    for para in paras:
        for run in para.runs:
            if not first_set:
                run.text = new_text
                first_set = True
            else:
                run.text = ""
    # If no runs found, add one
    if not first_set:
        from pptx.oxml.ns import qn
        para = paras[0]
        r_elem = para._p.makeelement(qn('a:r'), {})
        t_elem = r_elem.makeelement(qn('a:t'), {})
        t_elem.text = new_text
        r_elem.append(t_elem)
        para._p.append(r_elem)

def replace_para_text_by_content(shape, old_partial, new_text):
    """Find a paragraph containing old_partial and replace its text with new_text."""
    for para in shape.text_frame.paragraphs:
        if old_partial in para.text:
            set_paragraph_text(para, new_text)
            return True
    return False

# ─────────────────────────────────────────────────────────────────────────────
# SLIDE 1 - Title slide
# ─────────────────────────────────────────────────────────────────────────────
slide1 = prs.slides[0]
for shape in slide1.shapes:
    if shape.has_text_frame:
        if 'Lumbar Spondylolysis' in shape.text_frame.text or 'Lumbar Spondolysis' in shape.text_frame.text or '21-Year' in shape.text_frame.text:
            set_paragraph_text(
                shape.text_frame.paragraphs[0],
                "Physiotherapy Rehabilitation of Post-Stroke Hemiplegia in a 56-Year-Old Male"
            )
            break

# ─────────────────────────────────────────────────────────────────────────────
# SLIDE 2 - Case Background
# ─────────────────────────────────────────────────────────────────────────────
slide2 = prs.slides[1]
for shape in slide2.shapes:
    if shape.has_text_frame:
        txt = shape.text_frame.text
        if 'CASE BACKGROUND' in txt:
            set_paragraph_text(shape.text_frame.paragraphs[0], 'CASE BACKGROUND')
        elif '21 year old' in txt or 'Lower Back pain' in txt or 'stroke' in txt.lower() or 'complaint' in txt.lower():
            # This is the body text box
            tf = shape.text_frame
            # Clear all paragraphs text, set first non-empty
            new_body = ("Patient is 56 year old male who came to MYH OPD on 25/06/2026. "
                        "Patient came with the complaint of right side tightness, hypertonia of right upper and lower limb, "
                        "abnormal posture and inability to perform ADLs. He had a history of stroke 1 year back.")
            first_set = False
            for para in tf.paragraphs:
                for run in para.runs:
                    if not first_set:
                        run.text = new_body
                        first_set = True
                    else:
                        run.text = ""

# ─────────────────────────────────────────────────────────────────────────────
# SLIDE 3 - Introduction
# ─────────────────────────────────────────────────────────────────────────────
slide3 = prs.slides[2]
shapes3 = get_text_shapes(slide3)
for shape in slide3.shapes:
    if shape.has_text_frame:
        txt = shape.text_frame.text
        if 'INTRODUCTION' in txt:
            set_paragraph_text(shape.text_frame.paragraphs[0], 'INTRODUCTION')
        elif 'LUMBAR SPONDOLYSIS' in txt or 'LUMBAR SPONDYLOSIS' in txt.upper():
            set_paragraph_text(shape.text_frame.paragraphs[0], 'STROKE (CEREBROVASCULAR ACCIDENT)')
        elif 'Spondy' in txt or 'degenerative' in txt.lower():
            new_body = ("Stroke = sudden interruption of blood supply to the brain causing neurological deficits. "
                        "It is a leading cause of adult disability worldwide.\n"
                        "Common Consequences:\n"
                        "Right hemiplegia – weakness/paralysis of right side.\n"
                        "Hypertonia / Spasticity – increased muscle tone due to upper motor neuron lesion.\n"
                        "Abnormal posture – hemiplegic posture (flexed UL, extended LL).\n"
                        "Decreased balance and coordination.\n"
                        "Impaired ADL performance and gait.")
            first_set = False
            for para in shape.text_frame.paragraphs:
                for run in para.runs:
                    if not first_set:
                        run.text = new_body
                        first_set = True
                    else:
                        run.text = ""

# ─────────────────────────────────────────────────────────────────────────────
# SLIDE 4 - Anatomy
# ─────────────────────────────────────────────────────────────────────────────
slide4 = prs.slides[3]
for shape in slide4.shapes:
    if shape.has_text_frame:
        txt = shape.text_frame.text
        if 'ANATOMY' in txt and len(txt.strip()) < 20:
            set_paragraph_text(shape.text_frame.paragraphs[0], 'ANATOMY')
        elif 'lumbar spine' in txt.lower() or 'vertebrae' in txt.lower() or 'lumbar' in txt.lower():
            new_body = ("The brain is the primary organ affected in stroke. "
                        "Relevant structures include the motor cortex, internal capsule, corticospinal tract, and cerebellum. "
                        "The right hemisphere controls left-sided movement; left hemisphere controls right-sided movement. "
                        "The corticospinal tract carries voluntary motor signals; its damage causes upper motor neuron signs "
                        "including spasticity, hypertonia, and abnormal reflexes.")
            first_set = False
            for para in shape.text_frame.paragraphs:
                for run in para.runs:
                    if not first_set:
                        run.text = new_body
                        first_set = True
                    else:
                        run.text = ""

# ─────────────────────────────────────────────────────────────────────────────
# SLIDE 5 - Cont. Components
# ─────────────────────────────────────────────────────────────────────────────
slide5 = prs.slides[4]
for shape in slide5.shapes:
    if shape.has_text_frame:
        txt = shape.text_frame.text
        if 'Cont' in txt and len(txt.strip()) < 15:
            set_paragraph_text(shape.text_frame.paragraphs[0], 'Cont….')
        elif 'COMPONENTS' in txt or 'Lumbar vertebrae' in txt or 'L1' in txt:
            new_body = ("COMPONENTS\n"
                        "Corticospinal Tract: Descending motor pathway; damage leads to spasticity and weakness.\n"
                        "Internal Capsule: Dense white matter; most common site for ischemic stroke causing hemiplegia.\n"
                        "Motor Cortex (Primary): Controls voluntary movements of contralateral limbs.\n"
                        "Basal Ganglia: Involved in movement regulation; dysfunction causes rigidity and postural problems.\n"
                        "Cerebellum: Coordinates balance and smooth movement; affected in posterior circulation strokes.\n"
                        "Brainstem: Controls vital functions; involvement causes severe deficits.")
            first_set = False
            for para in shape.text_frame.paragraphs:
                for run in para.runs:
                    if not first_set:
                        run.text = new_body
                        first_set = True
                    else:
                        run.text = ""

# ─────────────────────────────────────────────────────────────────────────────
# SLIDE 6 - Epidemiology table
# ─────────────────────────────────────────────────────────────────────────────
slide6 = prs.slides[5]
for shape in slide6.shapes:
    if shape.has_text_frame and 'EPIDEMIOLOGY' in shape.text_frame.text:
        set_paragraph_text(shape.text_frame.paragraphs[0], 'EPIDEMIOLOGY OF STROKE')
    if shape.has_table:
        tbl = shape.table
        epi_data = [
            ('Parameter', 'Summary'),
            ('Incidence', '~13.7 million new strokes per year globally'),
            ('Prevalence', '~101 million people living with stroke worldwide'),
            ('Age group', 'Most common >55 years; risk doubles each decade after 55'),
            ('Sex', 'Slightly higher lifetime risk in women; higher age-adjusted incidence in men'),
            ('Mortality', '~5.5 million deaths per year globally'),
            ('Disability', 'Leading cause of long-term disability in adults'),
            ('', ''),  # row 7
            ('', ''),  # row 8
        ]
        for r_idx, row in enumerate(tbl.rows):
            if r_idx < len(epi_data):
                c0, c1 = epi_data[r_idx]
                if len(row.cells) > 0 and c0:
                    set_cell_text(row.cells[0], c0)
                elif len(row.cells) > 0:
                    set_cell_text(row.cells[0], '')
                if len(row.cells) > 1 and c1:
                    set_cell_text(row.cells[1], c1)
                elif len(row.cells) > 1:
                    set_cell_text(row.cells[1], '')

# ─────────────────────────────────────────────────────────────────────────────
# SLIDE 7 - Etiology / Risk Factors table
# ─────────────────────────────────────────────────────────────────────────────
slide7 = prs.slides[6]
for shape in slide7.shapes:
    if shape.has_text_frame and 'ETIOLOGY' in shape.text_frame.text:
        set_paragraph_text(shape.text_frame.paragraphs[0], 'ETIOLOGY / RISK FACTORS')
    if shape.has_table:
        tbl = shape.table
        rf_data = [
            ('Factor', 'Summary'),
            ('Hypertension', 'Most common modifiable risk factor'),
            ('Diabetes Mellitus', 'Increases risk of ischemic stroke'),
            ('Atrial Fibrillation / Cardiac disease', 'Cardioembolic stroke risk'),
            ('Dyslipidemia / High cholesterol', 'Promotes atherosclerosis'),
            ('Smoking and alcohol use', 'Independent modifiable risk factors'),
            ('Obesity and sedentary lifestyle', 'Increases cardiovascular risk'),
            ('Previous TIA or stroke history', 'High risk of recurrence'),
            ('Age > 55 years, male sex', 'Non-modifiable risk factors'),
        ]
        for r_idx, row in enumerate(tbl.rows):
            if r_idx < len(rf_data):
                c0, c1 = rf_data[r_idx]
                set_cell_text(row.cells[0], c0)
                if len(row.cells) > 1:
                    set_cell_text(row.cells[1], c1)

# ─────────────────────────────────────────────────────────────────────────────
# SLIDE 8 - Subjective Assessment
# ─────────────────────────────────────────────────────────────────────────────
slide8 = prs.slides[7]
for shape in slide8.shapes:
    if shape.has_text_frame:
        txt = shape.text_frame.text
        if 'SUBJECTIVE ASSESSMENT' in txt:
            pass  # Keep as-is
        elif '21yr old' in txt or 'Labourer' in txt or 'Low Back Pain' in txt or 'Name – XYZ' in txt:
            tf = shape.text_frame
            new_lines = [
                '   ● Name – XYZ ',
                '   ● Gender - Male',
                '   ● Age - 56 yr old',
                '   ● Occupation – Retired Labourer',
                '   ● Address – Khajrana, Indore',
                '   ● Dominance - Right handed',
                '   ● Mobile no. – 966908XXX',
                '   ● Date of Assessment - 25/06/2026',
                '   ● Chief Complaints - Patient came with the complaint of right-side tightness and stiffness, hypertonia of right upper and lower limb, abnormal hemiplegic posture, and difficulty in performing ADLs. He had a history of stroke 1 year ago and has been managing with medications.',
            ]
            # Map to actual text paragraphs (skip empty/space-only)
            text_paras = [p for p in tf.paragraphs if p.runs]
            for idx, new_line in enumerate(new_lines):
                if idx < len(text_paras):
                    set_paragraph_text(text_paras[idx], new_line)

# ─────────────────────────────────────────────────────────────────────────────
# SLIDE 9 - History of Present Illness
# ─────────────────────────────────────────────────────────────────────────────
slide9 = prs.slides[8]
new_hopi = [
    "Onset: The patient was apparently asymptomatic until 1 year ago when he suffered an ischemic stroke, developing sudden onset right-sided weakness and speech difficulty.",
    "Initial Management: He was admitted to the Neurology ward, received thrombolytic therapy and was discharged after 2 weeks with residual right hemiplegia.",
    "Progression: Over the following months, right-side spasticity and hypertonia gradually increased, limiting functional mobility and ADL performance.",
    "Neurology Consultation (23 June 2026): Due to persistent spasticity and functional limitations, he attended the Neurology OPD at MY Hospital and received medical treatment.",
    "Physiotherapy Referral (25 June 2026): As symptoms persisted, he was referred to the Physiotherapy OPD for comprehensive assessment and neuro-rehabilitation.",
]
for shape in slide9.shapes:
    if shape.has_text_frame:
        txt = shape.text_frame.text
        if 'low back pain' in txt.lower() or 'lifting a heavy weight' in txt.lower() or 'Onset:' in txt:
            tf = shape.text_frame
            paras_with_runs = [p for p in tf.paragraphs if p.runs]
            for idx, new_line in enumerate(new_hopi):
                if idx < len(paras_with_runs):
                    set_paragraph_text(paras_with_runs[idx], new_line)

# ─────────────────────────────────────────────────────────────────────────────
# SLIDE 10 - Objective Assessment
# ─────────────────────────────────────────────────────────────────────────────
slide10 = prs.slides[9]
for shape in slide10.shapes:
    if shape.has_text_frame:
        txt = shape.text_frame.text
        if 'OBJECTIVE ASSESSMENT' in txt:
            pass  # Keep title (or update slightly)
        elif 'ON OBSERVATION' in txt or 'Short Stride Gait' in txt or 'Flat Back' in txt:
            tf = shape.text_frame
            new_obs_lines = [
                'ON OBSERVATION:',
                'Body built: Mesomorphic',
                'Gait :  Circumduction gait (hemiplegic gait)',
                'Posture : Hemiplegic posture – right UL flexed & adducted, right LL extended',
            ]
            paras_with_runs = [p for p in tf.paragraphs if p.runs]
            for idx, new_line in enumerate(new_obs_lines):
                if idx < len(paras_with_runs):
                    set_paragraph_text(paras_with_runs[idx], new_line)
        elif 'ON PALPATION' in txt or 'Tenderness' in txt or 'Hamstrings' in txt:
            tf = shape.text_frame
            new_palp_lines = [
                'ON PALPATION:',
                'Tone: Increased (hypertonia) right UL and LL – Grade 2 Modified Ashworth Scale',
                'Tenderness: Present over right shoulder and right hip flexors',
                'Swelling: Absent',
                'Clonus: Present at right ankle',
                'Pelvic tilt: Oblique – elevated on right',
                'Muscle wasting: Right side upper and lower limb',
            ]
            paras_with_runs = [p for p in tf.paragraphs if p.runs]
            for idx, new_line in enumerate(new_palp_lines):
                if idx < len(paras_with_runs):
                    set_paragraph_text(paras_with_runs[idx], new_line)

# ─────────────────────────────────────────────────────────────────────────────
# SLIDE 11 - Medical/Drug History
# ─────────────────────────────────────────────────────────────────────────────
slide11 = prs.slides[10]
for shape in slide11.shapes:
    if shape.has_text_frame:
        txt = shape.text_frame.text
        if 'PAST MEDICAL HISTORY' in txt or 'Pregabalin' in txt or 'FAMILY HISTORY' in txt:
            tf = shape.text_frame
            new_hist_lines = [
                'PAST MEDICAL HISTORY – Ischemic Stroke 1 year back',
                'PAST HISTORY – Right hemiplegia and spasticity since 1 year',
                'PRESENT MEDICAL HISTORY - Tab. Aspirin 75mg, Tab. Atorvastatin 40mg, Tab. Baclofen 10mg, Tab. Amlodipine 5mg',
                'FAMILY HISTORY - Hypertension in father',
                'SOCIOECONOMIC STATUS – Middle class',
                'Personal history - Bowel/Bladder - Bladder urgency present, Appetite - normal',
                'Surgical History - None',
                'Environmental History – Lives in clean hygienic area',
            ]
            paras_with_runs = [p for p in tf.paragraphs if p.runs]
            for idx, new_line in enumerate(new_hist_lines):
                if idx < len(paras_with_runs):
                    set_paragraph_text(paras_with_runs[idx], new_line)

# ─────────────────────────────────────────────────────────────────────────────
# SLIDE 12 - Pain/Tone History
# ─────────────────────────────────────────────────────────────────────────────
slide12 = prs.slides[11]
for shape in slide12.shapes:
    if shape.has_text_frame:
        txt = shape.text_frame.text
        if 'PAIN HISTORY' in txt or 'Onset – Gradual' in txt or 'B/L lower limbs' in txt:
            tf = shape.text_frame
            new_pain_lines = [
                'TONE / TIGHTNESS HISTORY',
                'Onset – Gradual, following ischemic stroke 1 year ago',
                'Duration – Since 1 year, increased over last 3 months',
                'Site – Right upper limb and right lower limb',
                'Aggravating factors: Emotional stress, cold weather, physical exertion, voluntary effort',
                'Relieving factors: Warmth, slow passive stretching, relaxation techniques',
            ]
            paras_with_runs = [p for p in tf.paragraphs if p.runs]
            for idx, new_line in enumerate(new_pain_lines):
                if idx < len(paras_with_runs):
                    set_paragraph_text(paras_with_runs[idx], new_line)

# ─────────────────────────────────────────────────────────────────────────────
# SLIDE 13 - MMT Before Treatment
# ─────────────────────────────────────────────────────────────────────────────
slide13 = prs.slides[12]
# Title text
for shape in slide13.shapes:
    if shape.has_text_frame:
        txt = shape.text_frame.text.strip()
        if txt == 'MMT':
            pass  # Keep
        elif 'Before treatment' in txt:
            set_paragraph_text(shape.text_frame.paragraphs[0], 'Before treatment: 25/06/2026')

# Tables - there are two tables on slide 13
# Table 1 (Lower limb): keep structure, update Right values to 2-3/5, Left to 5/5
# Table 2 (Lumbar): replace with Upper Limb data for stroke
table_shapes = [s for s in slide13.shapes if s.has_table]
if len(table_shapes) >= 1:
    tbl1 = table_shapes[0].table
    # Lower limb MMT - Right side 2-3, Left 5
    mmt_before_ll = [
        # row 0: headers - keep
        None,
        # row 1: Hip Flexors
        ('3+', '5'),
        # row 2: Extensors
        ('3', '5'),
        # row 3: Abductors
        ('2', '5'),
        # row 4: Adductors
        ('3', '5'),
        # row 5: External rotators
        ('2', '5'),
        # row 6: Internal rotators
        ('3', '5'),
    ]
    for r_idx, row in enumerate(tbl1.rows):
        if r_idx > 0 and r_idx < len(mmt_before_ll) and mmt_before_ll[r_idx]:
            right_val, left_val = mmt_before_ll[r_idx]
            if len(row.cells) > 2:
                set_cell_text(row.cells[2], right_val)
            if len(row.cells) > 3:
                set_cell_text(row.cells[3], left_val)

if len(table_shapes) >= 2:
    tbl2 = table_shapes[1].table
    # Replace Lumbar table with Upper Limb MMT for stroke
    ul_mmt_data = [
        ('Upper limb', 'Movement', 'Grade'),
        ('Shoulder', 'Flexors', '2'),
        ('', 'Extensors', '3'),
        ('', 'Abductors', '2'),
        ('Elbow', 'Flexors', '3'),
        ('', 'Extensors', '2'),
        ('Wrist', 'Extensors', '2'),
    ]
    # Only update if the table has enough rows
    for r_idx, row in enumerate(tbl2.rows):
        if r_idx < len(ul_mmt_data):
            row_data = ul_mmt_data[r_idx]
            for c_idx, cell in enumerate(row.cells):
                if c_idx < len(row_data):
                    set_cell_text(cell, row_data[c_idx])

# ─────────────────────────────────────────────────────────────────────────────
# SLIDE 14 - ROM Before Treatment
# ─────────────────────────────────────────────────────────────────────────────
slide14 = prs.slides[13]
# Title text
for shape in slide14.shapes:
    if shape.has_text_frame and 'Range of motion Before' in shape.text_frame.text:
        pass  # Keep as-is

# Table 1 (Lower limb ROM): Right side reduced
table_shapes14 = [s for s in slide14.shapes if s.has_table]
if len(table_shapes14) >= 1:
    tbl1 = table_shapes14[0].table
    # Right: ~60-70% of normal, Left: normal
    rom_before_ll = [
        None,  # header row
        ('75', '120'),   # Hip Flexion: Right 75 (norm 120), Left 120
        ('10', '20'),    # Extension: Right 10 (norm 20), Left 20
        ('25', '45'),    # Abduction: Right 25 (norm 45), Left 45
        ('20', '30'),    # Adduction: Right 20 (norm 30), Left 30
        ('25', '45'),    # External rotation
        ('25', '45'),    # Internal rotation
    ]
    for r_idx, row in enumerate(tbl1.rows):
        if r_idx > 0 and r_idx < len(rom_before_ll) and rom_before_ll[r_idx]:
            right_val, left_val = rom_before_ll[r_idx]
            if len(row.cells) > 2:
                set_cell_text(row.cells[2], right_val)
            if len(row.cells) > 3:
                set_cell_text(row.cells[3], left_val)

if len(table_shapes14) >= 2:
    tbl2 = table_shapes14[1].table
    # Replace Lumbar ROM with Upper Limb ROM for stroke
    ul_rom_data = [
        ('Upper limb', 'range'),
        ('Shoulder Flexion', 'Rt.- 90 / Lt.- 180'),
        ('Shoulder Abduction', 'Rt.- 80 / Lt.- 180'),
        ('Elbow Flexion', 'Rt.- 100 / Lt.- 150'),
    ]
    for r_idx, row in enumerate(tbl2.rows):
        if r_idx < len(ul_rom_data):
            row_data = ul_rom_data[r_idx]
            for c_idx, cell in enumerate(row.cells):
                if c_idx < len(row_data):
                    set_cell_text(cell, row_data[c_idx])

# ─────────────────────────────────────────────────────────────────────────────
# SLIDE 15 - Special Tests
# ─────────────────────────────────────────────────────────────────────────────
slide15 = prs.slides[14]
for shape in slide15.shapes:
    if shape.has_table:
        tbl = shape.table
        special_tests = [
            ('NAME', 'RESULT', 'INTERPRETATION'),
            ('Modified Ashworth Scale (MAS)', 'Grade 2 right UL & LL', 'Moderate spasticity'),
            ('Fugl-Meyer Assessment', '45/100', 'Moderate impairment'),
            ('Berg Balance Scale', '28/56', 'Medium fall risk'),
            ('Clonus Test', 'Positive right ankle', 'UMN lesion sign'),
        ]
        # Check how many columns the table has
        num_cols = len(tbl.columns)
        for r_idx, row in enumerate(tbl.rows):
            if r_idx < len(special_tests):
                row_data = special_tests[r_idx]
                for c_idx, cell in enumerate(row.cells):
                    if c_idx < len(row_data):
                        set_cell_text(cell, row_data[c_idx])

# Also check if table has only 3 cols (NAME, RIGHT, LEFT) - update accordingly
for shape in slide15.shapes:
    if shape.has_table:
        tbl = shape.table
        if len(tbl.columns) == 3:
            special_tests_3col = [
                ('NAME', 'RESULT', 'INTERPRETATION'),
                ('Modified Ashworth Scale (MAS)', 'Grade 2 right UL & LL', 'Moderate spasticity'),
                ('Fugl-Meyer Assessment', '45/100', 'Moderate impairment'),
                ('Berg Balance Scale', '28/56', 'Medium fall risk'),
                ('Clonus Test', 'Positive right ankle', 'UMN lesion sign'),
            ]
            for r_idx, row in enumerate(tbl.rows):
                if r_idx < len(special_tests_3col):
                    row_data = special_tests_3col[r_idx]
                    for c_idx, cell in enumerate(row.cells):
                        if c_idx < len(row_data):
                            set_cell_text(cell, row_data[c_idx])

# ─────────────────────────────────────────────────────────────────────────────
# SLIDE 16 - Outcome Measures Pre
# ─────────────────────────────────────────────────────────────────────────────
slide16 = prs.slides[15]
for shape in slide16.shapes:
    if shape.has_text_frame:
        txt = shape.text_frame.text
        if 'NPRS' in txt and 'activity 7' in txt:
            tf = shape.text_frame
            paras_with_runs = [p for p in tf.paragraphs if p.runs]
            new_nprs = [
                'NPRS Scale – on activity 5/10',
                '              on rest – 2/10',
            ]
            for idx, new_line in enumerate(new_nprs):
                if idx < len(paras_with_runs):
                    set_paragraph_text(paras_with_runs[idx], new_line)

# ─────────────────────────────────────────────────────────────────────────────
# SLIDE 17 - Pre-assessment Disability Index
# ─────────────────────────────────────────────────────────────────────────────
slide17 = prs.slides[16]
for shape in slide17.shapes:
    if shape.has_text_frame:
        txt = shape.text_frame.text
        if 'OSWESTRY' in txt.upper() or 'PRE ASSES' in txt.upper():
            set_paragraph_text(shape.text_frame.paragraphs[0], 'PRE ASSES BARTHEL INDEX')
        elif 'DISABILITY SCORE' in txt or '26/50' in txt:
            set_paragraph_text(shape.text_frame.paragraphs[0], 'BARTHEL INDEX SCORE: 45/100 – MODERATE DEPENDENCE')

# ─────────────────────────────────────────────────────────────────────────────
# SLIDE 18 - Prescriptions (keep as-is, just title)
# ─────────────────────────────────────────────────────────────────────────────
# Title is already "PHYSIOTHERAPY OPD & NEURO PRESCRIPTIONS" - keep as-is

# ─────────────────────────────────────────────────────────────────────────────
# SLIDE 19 - Imaging Findings
# ─────────────────────────────────────────────────────────────────────────────
slide19 = prs.slides[18]
for shape in slide19.shapes:
    if shape.has_text_frame:
        txt = shape.text_frame.text
        if 'MRI FINDINGS' in txt or 'MRI / CT' in txt:
            set_paragraph_text(shape.text_frame.paragraphs[0], 'MRI / CT FINDINGS')
        # If there's a body text shape, add content
        # (Slide 19 only had title in the analysis - if there's a body placeholder, fill it)

# Check if there are other shapes to fill
for shape in slide19.shapes:
    if shape.has_text_frame:
        txt = shape.text_frame.text.strip()
        if txt and 'MRI' not in txt and 'CT' not in txt:
            new_mri = ("CT Brain (Plain): Hypodense area in left middle cerebral artery (MCA) territory – "
                       "suggestive of ischemic infarct. Left internal capsule and corona radiata involvement noted. "
                       "No hemorrhagic transformation. "
                       "MRI Brain (DWI): Restricted diffusion in left MCA territory confirming acute/subacute ischemic stroke.")
            first_set = False
            for para in shape.text_frame.paragraphs:
                for run in para.runs:
                    if not first_set:
                        run.text = new_mri
                        first_set = True
                    else:
                        run.text = ""

# ─────────────────────────────────────────────────────────────────────────────
# SLIDE 20 - Diagnosis
# ─────────────────────────────────────────────────────────────────────────────
slide20 = prs.slides[19]
for shape in slide20.shapes:
    if shape.has_text_frame:
        txt = shape.text_frame.text
        if 'DIAGNOSIS' in txt and len(txt.strip()) < 20:
            pass  # Keep title
        elif 'MEDICAL DIAGNOSIS' in txt or 'PHYSIOTHERAPY DIAGNOSIS' in txt or 'Lumbar spondolysis' in txt:
            tf = shape.text_frame
            new_diag_lines = [
                'MEDICAL DIAGNOSIS – Left MCA ischemic stroke with right hemiplegia and spastic hypertonia.',
                'PHYSIOTHERAPY DIAGNOSIS – Right-sided spastic hemiplegia with hypertonia, hemiplegic posture, circumduction gait, and impaired ADL function secondary to left MCA ischemic stroke.',
            ]
            paras_with_runs = [p for p in tf.paragraphs if p.runs]
            for idx, new_line in enumerate(new_diag_lines):
                if idx < len(paras_with_runs):
                    set_paragraph_text(paras_with_runs[idx], new_line)

# ─────────────────────────────────────────────────────────────────────────────
# SLIDE 21 - Problem List
# ─────────────────────────────────────────────────────────────────────────────
slide21 = prs.slides[20]
for shape in slide21.shapes:
    if shape.has_text_frame:
        txt = shape.text_frame.text
        if 'PROBLEM LIST' in txt and len(txt.strip()) < 20:
            set_paragraph_text(shape.text_frame.paragraphs[0], 'PROBLEM LIST')
        elif 'Patient Identified Problems' in txt or 'low back pain' in txt.lower() or 'Therapist Identify' in txt:
            tf = shape.text_frame
            new_prob_lines = [
                'Patient Identified Problems: The patient reports right-side tightness and stiffness limiting daily activities such as dressing, walking, and climbing stairs. He wants to regain independence and return to normal daily life.',
                'Therapist Identified Problems: The patient demonstrates right-sided hypertonia (MAS Grade 2), hemiplegic posture, circumduction gait, reduced right UL & LL strength (MMT 2-3/5), impaired balance (BBS 28/56), decreased coordination, and functional dependence secondary to post-stroke spasticity.',
            ]
            paras_with_runs = [p for p in tf.paragraphs if p.runs]
            for idx, new_line in enumerate(new_prob_lines):
                if idx < len(paras_with_runs):
                    set_paragraph_text(paras_with_runs[idx], new_line)

# ─────────────────────────────────────────────────────────────────────────────
# SLIDE 22 - ICF Model text
# ─────────────────────────────────────────────────────────────────────────────
slide22 = prs.slides[21]
# Only has "ICF Model" title - keep as-is per instructions

# ─────────────────────────────────────────────────────────────────────────────
# SLIDE 23 - ICF MODEL table
# ─────────────────────────────────────────────────────────────────────────────
slide23 = prs.slides[22]
for shape in slide23.shapes:
    if shape.has_table:
        tbl = shape.table
        icf_data = [
            ('Body Structure & Function', 'Activity Limitation', 'Participation Restriction'),
            ('Hypertonia right UL & LL', 'Difficulty walking', 'Unable to work'),
            ('Hemiplegia – right side weakness', 'Difficulty dressing and grooming', 'Limited social participation'),
            ('Abnormal hemiplegic posture', 'Difficulty climbing stairs', 'Dependent on family for daily activities'),
            ('Impaired balance (BBS 28/56)', 'Impaired ADL performance', 'Reduced quality of life'),
            ('Circumduction gait pattern', 'Reduced endurance for physical tasks', 'Financial impact due to limited mobility'),
        ]
        for r_idx, row in enumerate(tbl.rows):
            if r_idx < len(icf_data):
                for c_idx, cell in enumerate(row.cells):
                    if c_idx < len(icf_data[r_idx]):
                        set_cell_text(cell, icf_data[r_idx][c_idx])

# ─────────────────────────────────────────────────────────────────────────────
# SLIDE 24 - Contextual Factors
# ─────────────────────────────────────────────────────────────────────────────
slide24 = prs.slides[23]
for shape in slide24.shapes:
    if shape.has_table:
        tbl = shape.table
        ctx_data = [
            ('Facilitators – Personal Factors', 'Facilitators – Environmental Factors', 'Barriers – Personal Factors', 'Barriers – Environmental Factors'),
            ('Motivated patient, willing to participate in rehab', 'Accessible physiotherapy OPD at MY Hospital', 'Age 56, long duration of spasticity (1 year)', 'Home architectural barriers (stairs, narrow doors)'),
            ('Supportive family assisting with daily care', 'Family support during rehabilitation', 'Fear of falls affecting confidence', 'Limited community mobility support'),
            ('Following prescribed medications regularly', 'Prescribed medications (Baclofen, Aspirin)', 'Residual hypertonia affecting movement', 'Lack of assistive devices at home'),
        ]
        for r_idx, row in enumerate(tbl.rows):
            if r_idx < len(ctx_data):
                for c_idx, cell in enumerate(row.cells):
                    if c_idx < len(ctx_data[r_idx]):
                        set_cell_text(cell, ctx_data[r_idx][c_idx])

# ─────────────────────────────────────────────────────────────────────────────
# SLIDE 25 - Physiotherapy Treatment Goals
# ─────────────────────────────────────────────────────────────────────────────
slide25 = prs.slides[24]
for shape in slide25.shapes:
    if shape.has_table:
        tbl = shape.table
        goals_data = [
            ('Short-Term Goals (Week 1-2)', 'Long-Term Goals (Week 3-6)'),
            ('Reduce right-sided hypertonia and spasticity (MAS from 2 to 1).', 'Achieve functional independence in ADLs (Barthel Index > 70).'),
            ('Improve passive ROM of right UL & LL.', 'Improve right UL & LL strength to MMT Grade 4.'),
            ('Correct hemiplegic posture with anti-spasticity positioning.', 'Improve gait pattern – reduce circumduction, improve step length.'),
            ('Improve sitting and standing balance.', 'Improve balance (BBS > 45/56).'),
            ('Educate patient and family on positioning, home exercises and fall prevention.', 'Maximize functional independence and community participation.'),
        ]
        for r_idx, row in enumerate(tbl.rows):
            if r_idx < len(goals_data):
                for c_idx, cell in enumerate(row.cells):
                    if c_idx < len(goals_data[r_idx]):
                        set_cell_text(cell, goals_data[r_idx][c_idx])

# ─────────────────────────────────────────────────────────────────────────────
# SLIDE 26 - Phase 1
# ─────────────────────────────────────────────────────────────────────────────
slide26 = prs.slides[25]
for shape in slide26.shapes:
    if shape.has_table:
        tbl = shape.table
        phase1_data = [
            ('Exercise / Intervention', 'Frequency (F)', 'Intensity (I)', 'Time (T)', 'Type (T)'),
            ('Anti-spasticity positioning', 'Continuous / throughout day', 'Passive', 'All day', 'Bed positioning program'),
            ('Passive ROM exercises (right UL & LL)', '5 days/week', 'Gentle, full range', '10–15 min', 'All joints'),
            ('Slow prolonged stretching – spastic muscles', '5 days/week', 'Low', 'Hold 30 sec × 3–5 reps', 'Biceps, finger flexors, plantar flexors'),
            ('TENS – spastic muscle groups', '5 days/week', 'Sensory level', '10–15 min', 'Tone reduction'),
            ('Mat activities (rolling, bridging)', '5 days/week', 'Moderate', '10–15 min', 'Weight bearing & trunk control'),
            ('Diaphragmatic breathing & trunk relaxation', '3–5 days/week', 'Low', '5–10 min', 'Relaxation & breathing'),
        ]
        for r_idx, row in enumerate(tbl.rows):
            if r_idx < len(phase1_data):
                for c_idx, cell in enumerate(row.cells):
                    if c_idx < len(phase1_data[r_idx]):
                        set_cell_text(cell, phase1_data[r_idx][c_idx])

# ─────────────────────────────────────────────────────────────────────────────
# SLIDE 27 - Phase 2
# ─────────────────────────────────────────────────────────────────────────────
slide27 = prs.slides[26]
for shape in slide27.shapes:
    if shape.has_table:
        tbl = shape.table
        phase2_data = [
            ('Exercise / Intervention', 'Frequency (F)', 'Intensity (I)', 'Time (T)', 'Type (T)'),
            ('Active-assisted exercises – right UL & LL', '5 days/week', 'Low–Moderate', '10–15 min', 'Progressive strengthening'),
            ('NDT / Bobath techniques', '5 days/week', 'Moderate', '15–20 min', 'Reflex inhibiting postures, facilitation'),
            ('Balance training (sitting → standing)', '5 days/week', 'Moderate', '10–15 min', 'Weight shift, sitting/standing balance'),
            ('Gait retraining (parallel bars → tripod stick)', '5 days/week', 'Moderate', '15–20 min', 'Supervised walking, step training'),
            ('Task-specific ADL retraining', '5 days/week', 'Moderate', '10–15 min', 'Dressing, feeding, grooming'),
            ('Mirror therapy – right UL', '5 days/week', 'Low', '10–15 min', 'Motor facilitation'),
            ('FES (right wrist extensors & ankle dorsiflexors)', '5 days/week', 'Motor threshold', '20 min', 'Functional electrical stimulation'),
        ]
        for r_idx, row in enumerate(tbl.rows):
            if r_idx < len(phase2_data):
                for c_idx, cell in enumerate(row.cells):
                    if c_idx < len(phase2_data[r_idx]):
                        set_cell_text(cell, phase2_data[r_idx][c_idx])

# ─────────────────────────────────────────────────────────────────────────────
# SLIDE 28 - Images slide - no text changes
# ─────────────────────────────────────────────────────────────────────────────
# No changes needed

# ─────────────────────────────────────────────────────────────────────────────
# SLIDE 29 - MMT After Treatment
# ─────────────────────────────────────────────────────────────────────────────
slide29 = prs.slides[28]
for shape in slide29.shapes:
    if shape.has_text_frame:
        txt = shape.text_frame.text.strip()
        if txt == 'MMT':
            pass  # Keep
        elif 'After treatment' in txt:
            set_paragraph_text(shape.text_frame.paragraphs[0], 'After treatment: 06/07/2026')

table_shapes29 = [s for s in slide29.shapes if s.has_table]
if len(table_shapes29) >= 1:
    tbl1 = table_shapes29[0].table
    # Lower limb MMT after - Right side 3-4, Left 5
    mmt_after_ll = [
        None,  # header
        ('4', '5'),    # Hip Flexors
        ('4', '5'),    # Extensors
        ('3+', '5'),   # Abductors
        ('4', '5'),    # Adductors
        ('3+', '5'),   # External rotators
        ('4', '5'),    # Internal rotators
    ]
    for r_idx, row in enumerate(tbl1.rows):
        if r_idx > 0 and r_idx < len(mmt_after_ll) and mmt_after_ll[r_idx]:
            right_val, left_val = mmt_after_ll[r_idx]
            if len(row.cells) > 2:
                set_cell_text(row.cells[2], right_val)
            if len(row.cells) > 3:
                set_cell_text(row.cells[3], left_val)

if len(table_shapes29) >= 2:
    tbl2 = table_shapes29[1].table
    # Upper Limb MMT after treatment
    ul_mmt_after = [
        ('Upper limb', 'Movement', 'Grade'),
        ('Shoulder', 'Flexors', '4'),
        ('', 'Extensors', '4'),
        ('', 'Abductors', '3+'),
        ('Elbow', 'Flexors', '4'),
        ('', 'Extensors', '4'),
        ('Wrist', 'Extensors', '3+'),
    ]
    for r_idx, row in enumerate(tbl2.rows):
        if r_idx < len(ul_mmt_after):
            for c_idx, cell in enumerate(row.cells):
                if c_idx < len(ul_mmt_after[r_idx]):
                    set_cell_text(cell, ul_mmt_after[r_idx][c_idx])

# ─────────────────────────────────────────────────────────────────────────────
# SLIDE 30 - ROM After Treatment
# ─────────────────────────────────────────────────────────────────────────────
slide30 = prs.slides[29]
table_shapes30 = [s for s in slide30.shapes if s.has_table]
if len(table_shapes30) >= 1:
    tbl1 = table_shapes30[0].table
    # Lower limb ROM after - Right improved
    rom_after_ll = [
        None,
        ('105', '120'),   # Hip Flexion
        ('15', '20'),     # Extension
        ('35', '45'),     # Abduction
        ('25', '30'),     # Adduction
        ('35', '45'),     # External rotation
        ('35', '45'),     # Internal rotation
    ]
    for r_idx, row in enumerate(tbl1.rows):
        if r_idx > 0 and r_idx < len(rom_after_ll) and rom_after_ll[r_idx]:
            right_val, left_val = rom_after_ll[r_idx]
            if len(row.cells) > 2:
                set_cell_text(row.cells[2], right_val)
            if len(row.cells) > 3:
                set_cell_text(row.cells[3], left_val)

if len(table_shapes30) >= 2:
    tbl2 = table_shapes30[1].table
    # Upper Limb ROM after
    ul_rom_after = [
        ('Upper limb', 'range'),
        ('Shoulder Flexion', 'Rt.- 140 / Lt.- 180'),
        ('Shoulder Abduction', 'Rt.- 130 / Lt.- 180'),
        ('Elbow Flexion', 'Rt.- 130 / Lt.- 150'),
    ]
    for r_idx, row in enumerate(tbl2.rows):
        if r_idx < len(ul_rom_after):
            for c_idx, cell in enumerate(row.cells):
                if c_idx < len(ul_rom_after[r_idx]):
                    set_cell_text(cell, ul_rom_after[r_idx][c_idx])

# ─────────────────────────────────────────────────────────────────────────────
# SLIDE 31 - Outcome Measures Post
# ─────────────────────────────────────────────────────────────────────────────
slide31 = prs.slides[30]
for shape in slide31.shapes:
    if shape.has_text_frame:
        txt = shape.text_frame.text
        if 'NPRS' in txt and ('activity 4' in txt or 'activity' in txt.lower()):
            tf = shape.text_frame
            paras_with_runs = [p for p in tf.paragraphs if p.runs]
            new_nprs_post = [
                'NPRS Scale – on activity 3/10',
                '              on rest – 1/10',
            ]
            for idx, new_line in enumerate(new_nprs_post):
                if idx < len(paras_with_runs):
                    set_paragraph_text(paras_with_runs[idx], new_line)

# ─────────────────────────────────────────────────────────────────────────────
# SLIDE 32 - Post-assessment Disability Index
# ─────────────────────────────────────────────────────────────────────────────
slide32 = prs.slides[31]
for shape in slide32.shapes:
    if shape.has_text_frame:
        txt = shape.text_frame.text
        if 'OSWESTRY' in txt.upper() or 'POST ASSES' in txt.upper():
            set_paragraph_text(shape.text_frame.paragraphs[0], 'POST ASSES BARTHEL INDEX')
        elif 'DISABILITY SCORE' in txt or '10/50' in txt:
            set_paragraph_text(shape.text_frame.paragraphs[0], 'BARTHEL INDEX SCORE: 65/100 – MILD DEPENDENCE')

# ─────────────────────────────────────────────────────────────────────────────
# SLIDE 33 - Home Exercise Protocol
# ─────────────────────────────────────────────────────────────────────────────
slide33 = prs.slides[32]
for shape in slide33.shapes:
    if shape.has_table:
        tbl = shape.table
        hep_data = [
            ('Exercise / Advice', 'Frequency', 'Dosage / Time', 'Purpose'),
            ('Bicep stretch, finger extensor stretch, plantar flexor stretch', 'Daily', '3 × 30 sec', 'Reduce spasticity and improve flexibility'),
            ('Shoulder shrugs, elbow extension, wrist extension exercises', '5 days/week', '3 × 10 reps', 'Strengthen right UL'),
            ('Ankle dorsiflexion active exercises', '5 days/week', '3 × 10 reps', 'Strengthen right LL, improve gait'),
            ('Standing at wall support (bilateral)', '5 days/week', '3 × 30 sec hold', 'Improve standing balance'),
            ('Walking with stick – supervised', '5–7 days/week', '10–15 min twice daily', 'Gait training and endurance'),
            ('Anti-spasticity positioning at rest', 'Daily', 'All rest periods', 'Reduce tone, prevent contractures'),
            ('Mirror therapy – right UL (at home)', 'Daily', '10–15 min', 'Motor facilitation and neuroplasticity'),
            ('Diaphragmatic breathing & relaxation', 'Daily', '5–10 min', 'Reduce overall tone and stress'),
            ('Avoid prolonged immobility; change position every 2 hours', 'Daily', 'Throughout the day', 'Prevent pressure sores and stiffness'),
        ]
        for r_idx, row in enumerate(tbl.rows):
            if r_idx < len(hep_data):
                for c_idx, cell in enumerate(row.cells):
                    if c_idx < len(hep_data[r_idx]):
                        set_cell_text(cell, hep_data[r_idx][c_idx])

# ─────────────────────────────────────────────────────────────────────────────
# SLIDE 34 - Case Related Articles
# ─────────────────────────────────────────────────────────────────────────────
slide34 = prs.slides[33]
# Title is already "CASE RELATED ARTICLES" - keep
# Need to add body text if there's a content placeholder
for shape in slide34.shapes:
    if shape.has_text_frame:
        txt = shape.text_frame.text.strip()
        if txt == 'CASE RELATED ARTICLES':
            pass  # Keep title
        elif txt:  # Any other text shape
            new_articles = ("1. Veerbeek JM et al. (2014). What is the evidence for physical therapy poststroke? "
                           "A systematic review and meta-analysis. PLOS ONE.\n"
                           "2. Langhorne P et al. (2011). Motor recovery after stroke: a systematic review. Lancet Neurology.\n"
                           "3. Pollock A et al. (2014). Physical rehabilitation approaches for the recovery of mobility and lower limb function following stroke. Cochrane Database Syst Rev.\n"
                           "4. Bobath B (1990). Adult Hemiplegia: Evaluation and Treatment (3rd ed.). Heinemann Medical Books.")
            first_set = False
            for para in shape.text_frame.paragraphs:
                for run in para.runs:
                    if not first_set:
                        run.text = new_articles
                        first_set = True
                    else:
                        run.text = ""

# ─────────────────────────────────────────────────────────────────────────────
# SLIDE 35 - References
# ─────────────────────────────────────────────────────────────────────────────
slide35 = prs.slides[34]
for shape in slide35.shapes:
    if shape.has_text_frame:
        txt = shape.text_frame.text.strip()
        if 'REFERENCES' in txt.upper() and len(txt) < 30:
            pass  # Keep title
        elif 'Magee' in txt or 'Neumann' in txt or 'Muscolino' in txt or txt:
            tf = shape.text_frame
            new_ref_lines = [
                'Carr JH, Shepherd RB. (2010). Neurological Rehabilitation: Optimizing Motor Performance (2nd ed.). Churchill Livingstone.',
                'Bobath B. (1990). Adult Hemiplegia: Evaluation and Treatment (3rd ed.). Heinemann Medical Books.',
                'Shumway-Cook A, Woollacott MH. (2017). Motor Control: Translating Research into Clinical Practice (5th ed.). Wolters Kluwer.',
                "O'Sullivan SB, Schmitz TJ. (2019). Physical Rehabilitation (7th ed.). F.A. Davis Company.",
            ]
            paras_with_runs = [p for p in tf.paragraphs if p.runs]
            for idx, new_line in enumerate(new_ref_lines):
                if idx < len(paras_with_runs):
                    set_paragraph_text(paras_with_runs[idx], new_line)

# ─────────────────────────────────────────────────────────────────────────────
# SLIDE 36 - Thank You - Keep as-is
# ─────────────────────────────────────────────────────────────────────────────
# No changes needed

# ─────────────────────────────────────────────────────────────────────────────
# Save output
# ─────────────────────────────────────────────────────────────────────────────
prs.save(OUTPUT_PATH)
print(f"Saved to: {OUTPUT_PATH}")
print("SUCCESS")