from docx import Document
from docx.shared import Pt, Inches, RGBColor
from docx.enum.text import WD_ALIGN_PARAGRAPH
from docx.oxml.ns import qn
from docx.oxml import OxmlElement

doc = Document()

# ── Page setup (A4) ──────────────────────────────────────────────────────────
section = doc.sections[0]
section.page_width  = Inches(8.27)
section.page_height = Inches(11.69)
section.top_margin = section.bottom_margin = Inches(1)
section.left_margin = section.right_margin = Inches(1.1)

# ── Style helpers ────────────────────────────────────────────────────────────
normal = doc.styles["Normal"]
normal.font.name = "Times New Roman"
normal.font.size = Pt(12)

h1 = doc.styles["Heading 1"]
h1.font.name = "Times New Roman"; h1.font.size = Pt(16)
h1.font.bold = True; h1.font.color.rgb = RGBColor(0x00, 0x00, 0x00)

h2 = doc.styles["Heading 2"]
h2.font.name = "Times New Roman"; h2.font.size = Pt(14)
h2.font.bold = True; h2.font.color.rgb = RGBColor(0x00, 0x00, 0x00)

h3 = doc.styles["Heading 3"]
h3.font.name = "Times New Roman"; h3.font.size = Pt(12)
h3.font.bold = True; h3.font.color.rgb = RGBColor(0x00, 0x00, 0x00)

def centered_para(text, bold=False, size=12, space_before=0, space_after=6):
    p = doc.add_paragraph()
    p.alignment = WD_ALIGN_PARAGRAPH.CENTER
    p.paragraph_format.space_before = Pt(space_before)
    p.paragraph_format.space_after  = Pt(space_after)
    run = p.add_run(text)
    run.bold = bold
    run.font.name = "Times New Roman"
    run.font.size = Pt(size)
    return p

def body_para(text, bold=False, italic=False, size=12, space_after=4):
    p = doc.add_paragraph()
    p.alignment = WD_ALIGN_PARAGRAPH.JUSTIFY
    p.paragraph_format.space_after = Pt(space_after)
    run = p.add_run(text)
    run.bold   = bold
    run.italic = italic
    run.font.name = "Times New Roman"
    run.font.size = Pt(size)
    return p

def add_bullet(text, level=1, size=12):
    style_name = "List Bullet" if level == 1 else f"List Bullet {level}"
    p = doc.add_paragraph(style=style_name)
    p.paragraph_format.space_after = Pt(3)
    run = p.add_run(text)
    run.font.name = "Times New Roman"
    run.font.size = Pt(size)
    return p

def add_numbered(text, level=1, size=12):
    style_name = "List Number" if level == 1 else f"List Number {level}"
    p = doc.add_paragraph(style=style_name)
    p.paragraph_format.space_after = Pt(3)
    run = p.add_run(text)
    run.font.name = "Times New Roman"
    run.font.size = Pt(size)
    return p

def section_heading(text, level=1):
    h = doc.add_heading(text, level=level)
    h.alignment = WD_ALIGN_PARAGRAPH.LEFT
    h.paragraph_format.space_before = Pt(10)
    h.paragraph_format.space_after  = Pt(4)
    for run in h.runs:
        run.font.name = "Times New Roman"
    return h

def add_horizontal_rule():
    p = doc.add_paragraph()
    p.paragraph_format.space_before = Pt(2)
    p.paragraph_format.space_after  = Pt(2)
    pPr = p._p.get_or_add_pPr()
    pBdr = OxmlElement("w:pBdr")
    bottom = OxmlElement("w:bottom")
    bottom.set(qn("w:val"), "single")
    bottom.set(qn("w:sz"), "6")
    bottom.set(qn("w:space"), "1")
    bottom.set(qn("w:color"), "000000")
    pBdr.append(bottom)
    pPr.append(pBdr)

# ════════════════════════════════════════════════════════════════════════════
# TITLE PAGE
# ════════════════════════════════════════════════════════════════════════════
centered_para("3D INTERACTIVE MODEL OF KSHARA SUTRA THERAPY", bold=True, size=16, space_before=24, space_after=6)
centered_para("WITH CLINICAL CORRELATION", bold=True, size=16, space_after=20)
add_horizontal_rule()
centered_para("Topic", bold=True, size=13, space_before=14, space_after=4)
centered_para("3D Interactive Model of Kshara Sutra Changing", bold=False, size=13, space_after=20)
add_horizontal_rule()
centered_para(
    "\"Interactive 3D Kshara Sutra Model: Procedure of Kshara Sutra Changing\n"
    "in the Management of Bhagandara (Fistula-in-Ano)\"",
    bold=True, size=14, space_before=10, space_after=20
)
add_horizontal_rule()
centered_para("Subject: Shalya Tantra", bold=False, size=12, space_before=10, space_after=4)
centered_para("Department of Shalya Tantra", bold=False, size=12, space_after=4)
centered_para("Ayurveda College", bold=False, size=12, space_after=40)
centered_para("Academic Year: 2025–26", bold=False, size=12, space_after=0)

doc.add_page_break()

# ════════════════════════════════════════════════════════════════════════════
# SECTION 1 – AIM
# ════════════════════════════════════════════════════════════════════════════
section_heading("Aim", level=1)
body_para(
    "To develop a book-style, layered 3D interactive model demonstrating the step-by-step "
    "procedure of Kshara Sutra changing (weekly thread replacement) in the management of "
    "Bhagandara (Fistula-in-Ano), correlating Ayurvedic parasurgical principles with modern "
    "anorectal surgical practice."
)

# ════════════════════════════════════════════════════════════════════════════
# SECTION 2 – OBJECTIVES
# ════════════════════════════════════════════════════════════════════════════
section_heading("Objectives", level=1)
add_numbered("To understand the anatomy of the anal canal and perianal region relevant to Kshara Sutra changing.")
add_numbered("To demonstrate the position of the existing Kshara Sutra within the fistulous tract before changing.")
add_numbered("To explain the step-by-step technique of removing the old Kshara Sutra and replacing it with a fresh one.")
add_numbered("To illustrate the gradual cutting (Chhedikarma), curetting (Lekhana), and simultaneous healing (Ropana) produced after each weekly change.")
add_numbered("To demonstrate the assessment of the unit cutting rate and the expected duration of treatment.")
add_numbered("To correlate the Ayurvedic principle of Kshara Sutra with modern concepts of slow-cutting seton therapy.")

# ════════════════════════════════════════════════════════════════════════════
# SECTION 3 – CONCEPT OF THE MODEL
# ════════════════════════════════════════════════════════════════════════════
section_heading("Concept of the Model", level=1)
body_para(
    "The model opens like a book, with each page representing one anatomical or procedural layer. "
    "As each layer is lifted, deeper structures and successive stages of the Kshara Sutra changing "
    "procedure become visible. The final layer demonstrates the fresh Kshara Sutra placed and tied "
    "in position after removal of the old thread, simulating one complete weekly session."
)

# ── Layers ──
section_heading("Layer 1 – Perianal Surface (Procedural Starting Point)", level=2)
add_bullet("Perianal skin and gluteal folds")
add_bullet("External opening of the fistula with surrounding induration")
add_bullet("Previously tied Kshara Sutra visible externally (protruding loop)")
add_bullet("Artery forceps / probe depicted for initial identification")

section_heading("Layer 2 – Superficial Fascia and Ischioanal Space", level=2)
add_bullet("Superficial fascia")
add_bullet("Ischioanal fat pad")
add_bullet("Superficial perianal blood vessels")
add_bullet("Tract wall showing previous cutting and early fibrosis")

section_heading("Layer 3 – Muscular Layer", level=2)
add_bullet("External anal sphincter (EAS)")
add_bullet("Internal anal sphincter (IAS)")
add_bullet("Levator ani muscle")
add_bullet("Degree of sphincter involvement by the fistulous tract (intersphincteric / transsphincteric)")

section_heading("Layer 4 – Anal Canal with Internal Opening", level=2)
add_bullet("Anal canal")
add_bullet("Dentate line and anal columns")
add_bullet("Internal opening of the fistula at the dentate line")
add_bullet("Old Kshara Sutra looped through the full tract, tied externally")

section_heading("Layer 5 – Kshara Sutra Changing Procedure", level=2)
add_bullet("Step 1: Old Kshara Sutra identified, cut, and removed using a probe / Enema syringe flush if needed")
add_bullet("Step 2: Measurement of residual tract length before insertion of new thread")
add_bullet("Step 3: Fresh Kshara Sutra threaded onto a malleable probe")
add_bullet("Step 4: Probe introduced through the external opening, guided along the tract, and retrieved through the internal opening")
add_bullet("Step 5: New Kshara Sutra pulled through and tied without tension (Laghu-Granthana / loose-tie principle)")
add_bullet("Step 6: Dressing applied; next change scheduled after 7 days")
add_bullet("Demonstrated change in tract wall – cutting edge advanced, healed fibrotic band trailing")

# ════════════════════════════════════════════════════════════════════════════
# SECTION 4 – MATERIALS REQUIRED
# ════════════════════════════════════════════════════════════════════════════
section_heading("Materials Required", level=1)

# Table of materials
table = doc.add_table(rows=1, cols=3)
table.style = "Table Grid"
from docx.enum.table import WD_TABLE_ALIGNMENT
table.alignment = WD_TABLE_ALIGNMENT.CENTER

hdr_cells = table.rows[0].cells
for cell, text in zip(hdr_cells, ["S. No.", "Material", "Purpose / Representation"]):
    cell.text = text
    for run in cell.paragraphs[0].runs:
        run.bold = True
        run.font.name = "Times New Roman"
        run.font.size = Pt(11)

materials = [
    ("1", "Foam sheets (multi-colour)", "Different anatomical layers (skin, fat, muscle, mucosa)"),
    ("2", "EVA foam", "Soft, flexible layer for sphincter muscles"),
    ("3", "Cardboard / MDF base", "Rigid base and book-spine hinge"),
    ("4", "Transparent plastic sheet", "Anal canal mucosa and tract wall visibility"),
    ("5", "Flexible coloured pipes / IV tubing", "Blood vessels and fistulous tract"),
    ("6", "Cotton thread coated with turmeric + lime paste", "Old Kshara Sutra in situ"),
    ("7", "Fresh cotton thread with black coating", "New Kshara Sutra to be inserted"),
    ("8", "Malleable silver / aluminium wire", "Probe used for threading Kshara Sutra"),
    ("9", "Clay / modelling putty", "Tract wall induration, abscess cavity"),
    ("10", "Velcro / magnets", "Layer attachment for book-opening design"),
    ("11", "Hinges (book-style)", "Layer-by-layer opening mechanism"),
    ("12", "Acrylic colours", "Colour coding of anatomy and healing stages"),
    ("13", "Labels and colour-coded tags", "Identification of structures and steps"),
    ("14", "Small forceps / probe (real or model)", "Demonstration of procedural instruments"),
]

for row_data in materials:
    row = table.add_row().cells
    for cell, text in zip(row, row_data):
        cell.text = text
        for run in cell.paragraphs[0].runs:
            run.font.name = "Times New Roman"
            run.font.size = Pt(11)

doc.add_paragraph()  # spacing after table

# ════════════════════════════════════════════════════════════════════════════
# SECTION 5 – SPECIAL FEATURES
# ════════════════════════════════════════════════════════════════════════════
section_heading("Special Features", level=1)

section_heading("1. Layer-by-Layer Book Design", level=2)
body_para(
    "Each anatomical or procedural layer can be individually lifted, revealing progressively "
    "deeper structures and the next stage of the Kshara Sutra changing procedure."
)

section_heading("2. Dual-Thread Interactive Design", level=2)
add_bullet("Old Kshara Sutra (colour-coded: yellow-brown, representing the medicated thread after one week of action) is removable from the tract slot.")
add_bullet("New Kshara Sutra (colour-coded: black-green) can be re-inserted through the tract slot using the model probe, simulating the actual clinical procedure.")
add_bullet("The tie / knot can be re-enacted by students to understand Laghu-Granthana (loose tying technique).")

section_heading("3. Tract Wall Cutting & Healing Demonstration", level=2)
add_bullet("A removable flap on the tract wall shows: Week 0 (intact tract), Week 1 (shallow groove cut by Kshara), Week 2–3 (deepening cut with lateral fibrosis), Week 4+ (near-complete division with fibrotic bridge formation).")
add_bullet("The advancing cutting edge and the trailing healed margin are colour differentiated.")

section_heading("4. Unit Cutting Rate Scale", level=2)
add_bullet("A calibrated ruler strip on the model indicates the unit cutting rate (UCR): approximately 0.5–1 cm per week depending on the composition of the Kshara Sutra.")
add_bullet("Students can calculate approximate total duration of therapy = tract length (cm) ÷ UCR (cm/week).")

section_heading("5. Sphincter Preservation Indicator", level=2)
add_bullet("Sphincter muscle layers are marked with a colour-coded safety indicator that remains intact throughout all changing stages, visually demonstrating the sphincter-preserving nature of Kshara Sutra compared to conventional fistulotomy.")

section_heading("6. Fistula Type Toggle", level=2)
add_bullet("The model accommodates two interchangeable tract inserts: (a) Intersphincteric fistula tract and (b) Transsphincteric fistula tract.")
add_bullet("Students can swap inserts to understand how sphincter involvement affects the Kshara Sutra changing technique and duration.")

# ════════════════════════════════════════════════════════════════════════════
# SECTION 6 – STEP-BY-STEP PROCEDURE DEMONSTRATED BY THE MODEL
# ════════════════════════════════════════════════════════════════════════════
section_heading("Step-by-Step Kshara Sutra Changing Procedure Demonstrated by the Model", level=1)

steps = [
    ("Step 1 – Patient Preparation",
     ["Patient positioned in lithotomy position (demonstrated by posture indicator on base)",
      "Perianal area cleaned with antiseptic solution",
      "External opening and protruding Kshara Sutra thread identified"]),
    ("Step 2 – Identification of Old Kshara Sutra",
     ["Old Kshara Sutra thread identified at the external opening",
      "Artery forceps applied to the protruding end",
      "Gentle traction applied to confirm the thread is mobile within the tract"]),
    ("Step 3 – Removal of Old Kshara Sutra",
     ["Old Kshara Sutra cut close to the knot",
      "Thread pulled out through the external opening in a smooth, continuous motion",
      "Residual tract length measured with a probe (recorded for UCR calculation)"]),
    ("Step 4 – Tract Assessment",
     ["Malleable probe gently introduced to assess tract integrity, direction, and depth",
      "Discharge noted: minimal serous discharge indicates healthy granulation; purulent discharge suggests secondary infection"]),
    ("Step 5 – Preparation of New Kshara Sutra",
     ["Fresh Kshara Sutra (prepared by coating surgical thread with Apamarga Kshara, Haridra, and Snuhi latex – 21 coatings)",
      "Thread attached to the eye of the malleable probe",
      "Thread end folded and looped for secure attachment"]),
    ("Step 6 – Insertion of New Kshara Sutra",
     ["Probe introduced through the external opening",
      "Guided along the fistulous tract following its established course",
      "Probe tip retrieved through the internal opening at the dentate line using index finger guidance"]),
    ("Step 7 – Threading and Tying",
     ["New Kshara Sutra pulled through the entire tract",
      "Both ends of the thread brought together externally",
      "Thread tied using the Laghu-Granthana technique (loose tie – neither too tight nor too slack)",
      "Excess thread trimmed; thread end tucked or taped to prevent dislodgement"]),
    ("Step 8 – Post-Change Dressing and Instructions",
     ["Sitz bath advised (warm water with Triphala Kwatha or saline)",
      "Dietary advice: avoid constipation-causing foods; increase fibre and fluid intake",
      "Anupana: Triphala Churna at bedtime",
      "Next Kshara Sutra change scheduled after 7 days"]),
]

for title, bullets in steps:
    section_heading(title, level=2)
    for b in bullets:
        add_bullet(b)

# ════════════════════════════════════════════════════════════════════════════
# SECTION 7 – CLINICAL CORRELATION
# ════════════════════════════════════════════════════════════════════════════
section_heading("Clinical Correlation", level=1)

# Sub-table for comparison
section_heading("Kshara Sutra Therapy vs. Conventional Surgical Methods", level=2)

comp_table = doc.add_table(rows=1, cols=4)
comp_table.style = "Table Grid"
comp_table.alignment = WD_TABLE_ALIGNMENT.CENTER

hdr = comp_table.rows[0].cells
for cell, text in zip(hdr, ["Parameter", "Kshara Sutra", "Fistulotomy", "Fistulectomy"]):
    cell.text = text
    for run in cell.paragraphs[0].runs:
        run.bold = True
        run.font.name = "Times New Roman"
        run.font.size = Pt(10)

comparison_rows = [
    ("Anaesthesia required", "No / Local", "Spinal / GA", "Spinal / GA"),
    ("OPD / IPD", "OPD procedure", "IPD", "IPD"),
    ("Sphincter preservation", "Complete", "Partial risk", "Partial risk"),
    ("Recurrence rate", "Low (< 5%)", "Low to moderate", "Moderate"),
    ("Duration of treatment", "6–8 weeks avg.", "1–2 weeks healing", "2–3 weeks healing"),
    ("Simultaneous healing", "Yes (active)", "Post-op healing", "Post-op healing"),
    ("Blood loss", "Negligible", "Moderate", "Significant"),
    ("Cost-effectiveness", "High", "Moderate", "Low"),
    ("Ayurvedic principle", "Kshara + Sutra = chemical + mechanical", "Not applicable", "Not applicable"),
]

for row_data in comparison_rows:
    row = comp_table.add_row().cells
    for cell, text in zip(row, row_data):
        cell.text = text
        for run in cell.paragraphs[0].runs:
            run.font.name = "Times New Roman"
            run.font.size = Pt(10)

doc.add_paragraph()

section_heading("Bhagandara – Ayurvedic Classification Correlated with Modern Types", level=2)
add_bullet("Shataponaka Bhagandara → Intersphincteric fistula-in-ano")
add_bullet("Ushtragreeva Bhagandara → Horseshoe / High transsphincteric fistula")
add_bullet("Parisravi Bhagandara → Multiple external openings / complex fistula")
add_bullet("Shambukavarta Bhagandara → Spiral / circumferential fistula")
add_bullet("Unmargi Bhagandara → Fistula with unusual / aberrant course")

section_heading("Indications and Contraindications for Kshara Sutra Changing", level=2)
body_para("Indications:", bold=True)
add_bullet("Low anal fistula (intersphincteric, low transsphincteric)")
add_bullet("High anal fistula (suprasphincteric) – where fistulotomy risks sphincter damage")
add_bullet("Recurrent fistula after previous surgery")
add_bullet("Patients unfit for spinal / general anaesthesia")
add_bullet("Patients preferring Ayurvedic / minimally invasive management")

body_para("Contraindications:", bold=True)
add_bullet("Active perianal sepsis with large abscess (requires drainage first)")
add_bullet("Crohn's disease-associated fistula (relative)")
add_bullet("Malignant fistula")
add_bullet("Immunocompromised patients with uncontrolled comorbidities")

section_heading("Ayurvedic Pharmacological Properties of Kshara Sutra Components", level=2)
add_bullet("Snuhi (Euphorbia neriifolia) latex – Chedana (cutting), Lekhana (scraping), Pachana (digestive)")
add_bullet("Apamarga Kshara (Achyranthes aspera ash) – Kshara karma: chemical cauterisation, antimicrobial, wound-cleansing")
add_bullet("Haridra (Curcuma longa) – Shodhana (purifying), anti-inflammatory, antimicrobial (curcumin)")
add_bullet("Together: simultaneous cutting, wound-cleansing, and healing – the Tridosha-balancing action in wound management")

# ════════════════════════════════════════════════════════════════════════════
# SECTION 8 – EDUCATIONAL ADVANTAGES
# ════════════════════════════════════════════════════════════════════════════
section_heading("Educational Advantages", level=1)
add_numbered("Easy, hands-on visualization of the Kshara Sutra changing procedure without the need for a patient or clinical setting.")
add_numbered("Interactive understanding of the anatomical landmarks relevant to safe thread changing.")
add_numbered("Demonstrates the distinction between old (spent) and new Kshara Sutra – their appearance, pharmacological coating, and thread condition after one week.")
add_numbered("The cutting rate scale helps students calculate treatment duration for a given fistula tract.")
add_numbered("The sphincter safety indicator reinforces the key advantage of Kshara Sutra over conventional fistulotomy.")
add_numbered("Suitable for undergraduate Ayurveda (Shalya Tantra) demonstrations, clinical skill labs, conferences, and exhibitions.")
add_numbered("Promotes integration of Ayurvedic parasurgical knowledge with evidence-based modern surgical correlation.")

# ════════════════════════════════════════════════════════════════════════════
# SECTION 9 – EXPECTED OUTCOME
# ════════════════════════════════════════════════════════════════════════════
section_heading("Expected Outcome", level=1)
body_para(
    "The completed 3D interactive model will function as a reusable educational tool that enables "
    "students of Shalya Tantra to confidently understand and demonstrate the Kshara Sutra changing "
    "procedure. By physically simulating each step – from removal of the spent thread to insertion "
    "and tying of the fresh Kshara Sutra – the model bridges the gap between theoretical knowledge "
    "and practical clinical skill. Students will be able to appreciate the progressive healing "
    "mechanism, understand the unit cutting rate concept, and recognize the sphincter-preserving "
    "superiority of Kshara Sutra therapy over conventional surgical options. The model will also "
    "serve as an effective exhibit at academic events and seminars, showcasing the scientific "
    "rationale of Ayurvedic parasurgery in contemporary anorectal care."
)

# ════════════════════════════════════════════════════════════════════════════
# SECTION 10 – REFERENCES
# ════════════════════════════════════════════════════════════════════════════
section_heading("References", level=1)
refs = [
    "Sushruta Samhita – Nidanasthana, Chapter 4 (Bhagandara Nidana); Chikitsasthana, Chapter 17 (Bhagandara Chikitsa). Edited by Vaidya Jadavaji Trikamji Acharya. Chaukhamba Sanskrit Pratishthan, Varanasi.",
    "Acharya YT (Ed.). Sushruta Samhita with Nibandhasangraha commentary of Dalhana. Chaukhamba Sanskrit Pratishthan, Varanasi; 2014.",
    "Singh K, Sharma JD, Gupta V. Kshara Sutra therapy in fistula-in-ano: A clinical study. Journal of Research in Ayurveda and Siddha. 1993;14(3-4):109-117.",
    "Deshpande PJ, Sharma KR. Treatment of fistula-in-ano by a new technique. Review and follow-up of 200 cases. Am J Proctol. 1976;27(2):41-7.",
    "Aggarwal SK, Kumar S, Pitalia AK. Kshara Sutra treatment of fistula-in-ano – a prospective study. J Indian Med Assoc. 1999;97(9):361-363.",
    "Indian Council of Medical Research (ICMR). Multicentric study on Kshara Sutra treatment for fistula-in-ano. New Delhi: ICMR; 1996.",
    "Williams NS, Bulstrode CJK, O'Connell PR (Eds.). Bailey & Love's Short Practice of Surgery. 26th edition. CRC Press; 2013. Chapter on Anus and Anal Canal.",
    "Corman ML. Colon and Rectal Surgery. 5th edition. Lippincott Williams & Wilkins; 2005.",
    "Parks AG, Gordon PH, Hardcastle JD. A classification of fistula-in-ano. Br J Surg. 1976;63(1):1-12.",
    "Raveenthiran V. Knowledge of Sushruta on Fistula-in-Ano (Bhagandara). Indian J Surg. 2011;73(2):97-101.",
]
for i, ref in enumerate(refs, 1):
    p = doc.add_paragraph(style="List Number")
    p.paragraph_format.space_after = Pt(4)
    run = p.add_run(ref)
    run.font.name = "Times New Roman"
    run.font.size = Pt(11)

# ════════════════════════════════════════════════════════════════════════════
# SAVE
# ════════════════════════════════════════════════════════════════════════════
output_path = "/tmp/workspace/kshara-sutra-project/Kshara_Sutra_Changing_3D_Model.docx"
doc.save(output_path)
print(f"Document saved: {output_path}")