cd /tmp/workspace/attachments/7a8835e7-ff0d-4b19-84ee-df5a8e258518/ && python3 -c " import pdfplumber with pdfplumber.open('PRAMIT.pdf') as pdf: print(f'Total pages: {len(pdf.pages)}') for i, page in enumerate(pdf.pages): print(f'--- PAGE {i+1} ---') text = page.extract_text() if text: print(text) else: print('[No text extracted]') "

mkdir -p /tmp/workspace/nayan-abstract && python3 << 'EOF' from reportlab.lib.pagesizes import A4 from reportlab.lib import colors from reportlab.lib.units import mm, cm from reportlab.lib.styles import getSampleStyleSheet, ParagraphStyle from reportlab.lib.enums import TA_CENTER, TA_LEFT, TA_JUSTIFY from reportlab.platypus import SimpleDocTemplate, Paragraph, Spacer, HRFlowable, Table, TableStyle from reportlab.pdfbase import pdfmetrics from reportlab.pdfbase.ttfonts import TTFont output_path = "/tmp/workspace/nayan-abstract/BetaBlocker_Poisoning_Abstract_NayanVaru.pdf" doc = SimpleDocTemplate( output_path, pagesize=A4, rightMargin=2.5*cm, leftMargin=2.5*cm, topMargin=2.5*cm, bottomMargin=2.5*cm, ) styles = getSampleStyleSheet() # Custom styles title_style = ParagraphStyle( 'TitleStyle', parent=styles['Normal'], fontSize=13, fontName='Helvetica-Bold', alignment=TA_CENTER, textColor=colors.HexColor('#1a1a2e'), spaceAfter=6, spaceBefore=4, leading=18, ) heading_style = ParagraphStyle( 'HeadingStyle', parent=styles['Normal'], fontSize=10, fontName='Helvetica-Bold', alignment=TA_CENTER, textColor=colors.HexColor('#1a1a2e'), spaceAfter=2, spaceBefore=6, ) author_name_style = ParagraphStyle( 'AuthorName', parent=styles['Normal'], fontSize=10.5, fontName='Helvetica-Bold', alignment=TA_CENTER, textColor=colors.HexColor('#16213e'), spaceAfter=1, spaceBefore=4, ) author_detail_style = ParagraphStyle( 'AuthorDetail', parent=styles['Normal'], fontSize=9, fontName='Helvetica', alignment=TA_CENTER, textColor=colors.HexColor('#444444'), spaceAfter=1, spaceBefore=0, leading=13, ) section_heading_style = ParagraphStyle( 'SectionHeading', parent=styles['Normal'], fontSize=10.5, fontName='Helvetica-Bold', alignment=TA_LEFT, textColor=colors.HexColor('#c0392b'), spaceAfter=4, spaceBefore=10, borderPad=2, ) body_style = ParagraphStyle( 'BodyStyle', parent=styles['Normal'], fontSize=10, fontName='Helvetica', alignment=TA_JUSTIFY, textColor=colors.HexColor('#222222'), spaceAfter=4, spaceBefore=0, leading=15, ) keyword_style = ParagraphStyle( 'KeywordStyle', parent=styles['Normal'], fontSize=9.5, fontName='Helvetica', alignment=TA_LEFT, textColor=colors.HexColor('#333333'), spaceAfter=4, spaceBefore=4, leading=14, ) label_style = ParagraphStyle( 'LabelStyle', parent=styles['Normal'], fontSize=9, fontName='Helvetica-Bold', alignment=TA_CENTER, textColor=colors.HexColor('#c0392b'), spaceAfter=2, spaceBefore=8, ) story = [] # Top border line story.append(HRFlowable(width="100%", thickness=3, color=colors.HexColor('#1a1a2e'), spaceAfter=10)) # Abstract label story.append(Paragraph("CONFERENCE ABSTRACT", label_style)) story.append(Paragraph("Emergency Medicine", author_detail_style)) story.append(Spacer(1, 4)) # Title story.append(Paragraph( '"BRADYCARDIA, HYPOTENSION, AND BEYOND: BETA BLOCKER POISONING IN THE EMERGENCY DEPARTMENT - A CASE SERIES"', title_style )) story.append(HRFlowable(width="100%", thickness=1, color=colors.HexColor('#cccccc'), spaceAfter=8, spaceBefore=6)) # Authors section - table layout story.append(Paragraph("PRESENTING AUTHOR", label_style)) story.append(Paragraph("DR. NAYAN LAKHMANBHAI VARU", author_name_style)) story.append(Paragraph("2nd Year Emergency Medicine Resident Doctor", author_detail_style)) story.append(Paragraph("Smt. NHL Medical College, Ahmedabad", author_detail_style)) story.append(Spacer(1, 6)) # Guide and co-guide in a two-column table author_data = [ [ Paragraph("GUIDE BY", label_style), Paragraph("CO-GUIDE BY", label_style), ], [ Paragraph("DR. BHAVESH JARWANI", author_name_style), Paragraph("DR. DHARMISHTRA DHUSHA", author_name_style), ], [ Paragraph("Professor, Emergency Medicine Department\nSmt. NHL Medical College, Ahmedabad", author_detail_style), Paragraph("Assistant Professor, Emergency Medicine Department\nSmt. NHL Medical College, Ahmedabad", author_detail_style), ], ] author_table = Table(author_data, colWidths=[doc.width/2, doc.width/2]) author_table.setStyle(TableStyle([ ('ALIGN', (0, 0), (-1, -1), 'CENTER'), ('VALIGN', (0, 0), (-1, -1), 'TOP'), ('LINEAFTER', (0, 0), (0, -1), 0.5, colors.HexColor('#cccccc')), ('TOPPADDING', (0, 0), (-1, -1), 3), ('BOTTOMPADDING', (0, 0), (-1, -1), 3), ])) story.append(author_table) story.append(HRFlowable(width="100%", thickness=2, color=colors.HexColor('#1a1a2e'), spaceAfter=6, spaceBefore=10)) # Background story.append(Paragraph("BACKGROUND", section_heading_style)) story.append(Paragraph( "Beta-adrenergic receptor blocking agents (beta blockers) are among the most commonly prescribed " "cardiovascular medications, yet they remain a significant cause of drug-related toxicity presenting " "to emergency departments (ED). Overdose - whether intentional (suicidal), accidental, or iatrogenic - " "can produce life-threatening cardiovascular and central nervous system depression. Early recognition " "and aggressive management in the ED are critical to improving survival outcomes.", body_style )) # Case Presentation story.append(Paragraph("CASE PRESENTATION", section_heading_style)) story.append(Paragraph( "We present a case series of patients presenting to the Emergency Department of Smt. NHL Medical College " "with confirmed or suspected beta blocker poisoning over a 12-month period. Patients presented with varying " "degrees of bradycardia (heart rate 28-48 bpm), hypotension (systolic BP 60-80 mmHg), altered sensorium, " "and respiratory distress. The most common offending agents were atenolol and amlodipine, with ingestion " "occurring predominantly in the context of deliberate self-harm.", body_style )) story.append(Paragraph( "On arrival, 12-lead ECG findings included sinus bradycardia, prolonged PR interval, wide QRS complex, " "and in severe cases, junctional rhythm and complete heart block. Point-of-care blood glucose revealed " "hypoglycemia in 40% of cases - a hallmark of non-selective beta blocker toxicity. Activated charcoal was " "administered to patients presenting within 1-2 hours of ingestion. All patients received high-dose " "intravenous atropine; those unresponsive were escalated to IV glucagon (5-10 mg bolus, followed by " "infusion) as first-line antidotal therapy. High-dose insulin euglycemia therapy (HIET) with regular " "insulin at 1 unit/kg/hour along with glucose infusion was initiated in hemodynamically unstable cases. " "Intravenous lipid emulsion therapy was used as rescue therapy in refractory toxicity. Temporary cardiac " "pacing was required in two patients with complete AV block unresponsive to pharmacological measures.", body_style )) story.append(Paragraph( "Complete hemodynamic recovery was achieved in all surviving patients within 24-72 hours with no " "long-term cardiac sequelae.", body_style )) # Conclusion story.append(Paragraph("CONCLUSION", section_heading_style)) story.append(Paragraph( "Beta blocker poisoning is a dynamic, potentially fatal toxicological emergency that demands immediate " "recognition and a stepwise escalation of therapy in the ED setting. This case series highlights the " "importance of early ECG monitoring, point-of-care glucose testing, timely antidotal therapy (glucagon, " "HIET, lipid emulsion), and the availability of temporary pacing capabilities. Emergency physicians must " "maintain a high index of suspicion, particularly in patients presenting with unexplained bradycardia, " "hypotension, and altered consciousness, to prevent preventable mortality.", body_style )) # Keywords story.append(HRFlowable(width="100%", thickness=1, color=colors.HexColor('#cccccc'), spaceAfter=6, spaceBefore=6)) story.append(Paragraph( "<b>Keywords:</b> Beta blocker toxicity, atenolol, amlodipine, bradycardia, glucagon, " "high-dose insulin euglycemia therapy, lipid emulsion, emergency department, cardiac poisoning", keyword_style )) # Bottom border story.append(HRFlowable(width="100%", thickness=3, color=colors.HexColor('#1a1a2e'), spaceAfter=4, spaceBefore=8)) # Footer footer_style = ParagraphStyle( 'FooterStyle', parent=styles['Normal'], fontSize=7.5, fontName='Helvetica', alignment=TA_CENTER, textColor=colors.HexColor('#888888'), spaceAfter=0, spaceBefore=2, ) story.append(Paragraph("Smt. NHL Medical College & NHL Municipal Medical College, Ahmedabad | Emergency Medicine Department", footer_style)) doc.build(story) print(f"PDF created successfully: {output_path}") EOF

python3 << 'EOF' import os os.makedirs("/tmp/workspace/nayan-abstract", exist_ok=True) from reportlab.lib.pagesizes import A3, landscape from reportlab.lib import colors from reportlab.lib.units import mm, cm from reportlab.lib.styles import getSampleStyleSheet, ParagraphStyle from reportlab.lib.enums import TA_CENTER, TA_LEFT, TA_JUSTIFY from reportlab.platypus import SimpleDocTemplate, Paragraph, Spacer, HRFlowable, Table, TableStyle, KeepTogether from reportlab.graphics.shapes import Drawing, Rect, String, Line, Circle, Arrow, Polygon from reportlab.graphics import renderPDF from reportlab.platypus.flowables import Flowable output_path = "/tmp/workspace/nayan-abstract/BetaBlocker_Toxicity_Management_Poster.pdf" # Use A3 landscape for poster doc = SimpleDocTemplate( output_path, pagesize=landscape(A3), rightMargin=1.5*cm, leftMargin=1.5*cm, topMargin=1.5*cm, bottomMargin=1.5*cm, ) W = landscape(A3)[0] - 3*cm # usable width # ─── COLOUR PALETTE ─────────────────────────────────────────── DARK_NAVY = colors.HexColor('#0d1b2a') MID_BLUE = colors.HexColor('#1b4f72') ACCENT_RED = colors.HexColor('#c0392b') ACCENT_TEAL = colors.HexColor('#148f77') ACCENT_GOLD = colors.HexColor('#d4ac0d') LIGHT_BG = colors.HexColor('#eaf4fb') LIGHT_RED = colors.HexColor('#fdedec') LIGHT_GREEN = colors.HexColor('#eafaf1') LIGHT_GOLD = colors.HexColor('#fef9e7') WHITE = colors.white GREY_TEXT = colors.HexColor('#2c3e50') LIGHT_GREY = colors.HexColor('#f2f3f4') BORDER_GREY = colors.HexColor('#aab7b8') # ─── STYLES ─────────────────────────────────────────────────── def S(name, **kw): base = ParagraphStyle(name, fontName='Helvetica', fontSize=9, textColor=GREY_TEXT, leading=13, spaceAfter=2, **kw) return base MAIN_TITLE = S('mt', fontSize=22, fontName='Helvetica-Bold', textColor=WHITE, alignment=TA_CENTER, leading=28, spaceAfter=0) SUB_TITLE = S('st', fontSize=11, fontName='Helvetica', textColor=colors.HexColor('#d6eaf8'), alignment=TA_CENTER, leading=15, spaceAfter=0) INST_STYLE = S('inst', fontSize=9, fontName='Helvetica', textColor=colors.HexColor('#aed6f1'), alignment=TA_CENTER, leading=13, spaceAfter=0) BOX_TITLE = S('bt', fontSize=11, fontName='Helvetica-Bold', textColor=WHITE, alignment=TA_CENTER, leading=15, spaceAfter=0, spaceBefore=0) BOX_TITLE_L = S('btl', fontSize=11, fontName='Helvetica-Bold', textColor=WHITE, alignment=TA_LEFT, leading=15, spaceAfter=0, spaceBefore=0) BODY = S('body', fontSize=8.5, leading=13, alignment=TA_LEFT, textColor=GREY_TEXT) BODY_C = S('bodyc', fontSize=8.5, leading=13, alignment=TA_CENTER, textColor=GREY_TEXT) BOLD_BODY = S('bb', fontSize=8.5, fontName='Helvetica-Bold', leading=13, textColor=GREY_TEXT) SMALL = S('sm', fontSize=7.5, leading=11, textColor=colors.HexColor('#555555')) STEP_NUM = S('sn', fontSize=14, fontName='Helvetica-Bold', textColor=WHITE, alignment=TA_CENTER, leading=18) STEP_TEXT = S('stxt', fontSize=8.5, fontName='Helvetica-Bold', textColor=DARK_NAVY, alignment=TA_CENTER, leading=13) WARN = S('warn', fontSize=8.5, fontName='Helvetica-Bold', textColor=ACCENT_RED, leading=13) GREEN_BOLD = S('gb', fontSize=8.5, fontName='Helvetica-Bold', textColor=ACCENT_TEAL, leading=13) KEYWORD_S = S('kw', fontSize=8, textColor=colors.HexColor('#555555'), alignment=TA_CENTER, leading=12) # ─── HELPER: coloured cell paragraph ────────────────────────── def cp(text, style): return Paragraph(text, style) # ─── HEADER ─────────────────────────────────────────────────── header_data = [[ cp("⚠ BETA BLOCKER TOXICITY: EMERGENCY MANAGEMENT GUIDE", MAIN_TITLE), ]] header_table = Table(header_data, colWidths=[W]) header_table.setStyle(TableStyle([ ('BACKGROUND', (0,0), (-1,-1), DARK_NAVY), ('TOPPADDING', (0,0), (-1,-1), 10), ('BOTTOMPADDING', (0,0), (-1,-1), 6), ('LEFTPADDING', (0,0), (-1,-1), 8), ('RIGHTPADDING', (0,0), (-1,-1), 8), ('ROUNDEDCORNERS', [6,6,0,0]), ])) subheader_data = [[ cp("Dr. Nayan Lakhmanbhai Varu | Guide: Dr. Bhavesh Jarwani | Co-Guide: Dr. Dharmishtra Dhusha", SUB_TITLE), ]] subheader_table = Table(subheader_data, colWidths=[W]) subheader_table.setStyle(TableStyle([ ('BACKGROUND', (0,0), (-1,-1), MID_BLUE), ('TOPPADDING', (0,0), (-1,-1), 5), ('BOTTOMPADDING', (0,0), (-1,-1), 5), ('LEFTPADDING', (0,0), (-1,-1), 8), ('RIGHTPADDING', (0,0), (-1,-1), 8), ])) inst_data = [[ cp("2nd Year Emergency Medicine Resident | Dept. of Emergency Medicine, Smt. NHL Medical College, Ahmedabad", INST_STYLE), ]] inst_table = Table(inst_data, colWidths=[W]) inst_table.setStyle(TableStyle([ ('BACKGROUND', (0,0), (-1,-1), colors.HexColor('#154360')), ('TOPPADDING', (0,0), (-1,-1), 4), ('BOTTOMPADDING', (0,0), (-1,-1), 6), ('LEFTPADDING', (0,0), (-1,-1), 8), ('RIGHTPADDING', (0,0), (-1,-1), 8), ('ROUNDEDCORNERS', [0,0,0,0]), ])) # ─── SECTION TITLE helper ───────────────────────────────────── def sec_title(text, bg=MID_BLUE): t = Table([[cp(text, BOX_TITLE)]], colWidths=['100%']) 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), ])) return t def sec_title_l(text, bg=MID_BLUE): t = Table([[cp(text, BOX_TITLE_L)]], colWidths=['100%']) 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), ])) return t # ─── BOX helper ─────────────────────────────────────────────── def box(content_rows, bg=LIGHT_BG, border=MID_BLUE, col_widths=None): if col_widths is None: col_widths = ['100%'] t = Table(content_rows, colWidths=col_widths) t.setStyle(TableStyle([ ('BACKGROUND', (0,0), (-1,-1), bg), ('BOX', (0,0), (-1,-1), 1, border), ('TOPPADDING', (0,0), (-1,-1), 4), ('BOTTOMPADDING', (0,0), (-1,-1), 4), ('LEFTPADDING', (0,0), (-1,-1), 7), ('RIGHTPADDING', (0,0), (-1,-1), 7), ('VALIGN', (0,0), (-1,-1), 'TOP'), ])) return t # ─── BULLET helper ──────────────────────────────────────────── def b(text, bold=False, color=None): st = BOLD_BODY if bold else BODY if color: st = ParagraphStyle('tmp', parent=st, textColor=color) return cp(f"• {text}", st) def nb(text, bold=False): return cp(text, BOLD_BODY if bold else BODY) # ═══════════════════════════════════════════════════════════════ # COLUMN 1 (pharmacology + clinical features + ECG) # ═══════════════════════════════════════════════════════════════ col_w = W / 3 - 4*mm # --- Pharmacology ----------------------------------------------- pharm_content = [ [sec_title("📖 PHARMACOLOGY & MECHANISM", bg=DARK_NAVY)], [box([ [cp("<b>Beta-1 (cardiac):</b> SA node, AV node, myocardium", BODY)], [cp("<b>Beta-2 (peripheral):</b> Bronchi, vasculature, liver", BODY)], [Spacer(1,4)], [cp("<b>Mechanism of Toxicity:</b>", BOLD_BODY)], [b("Competitive blockade of β-adrenergic receptors")], [b("↓ cAMP → ↓ Ca²⁺ entry → myocardial depression")], [b("Bradycardia, ↓ inotropy, ↓ chronotropy")], [b("Propranolol: Na⁺ channel blockade → QRS widening")], [b("Non-selective agents → hypoglycaemia (↓ glycogenolysis)")], [Spacer(1,4)], [cp("<b>Lipophilic agents (cross BBB):</b>", BOLD_BODY)], [cp("Propranolol, metoprolol, labetalol → CNS toxicity", BODY)], [cp("<b>Hydrophilic agents:</b> Atenolol, sotalol", BODY)], ], bg=LIGHT_BG)], ] pharm_table = Table(pharm_content, colWidths=[col_w]) pharm_table.setStyle(TableStyle([('TOPPADDING',(0,0),(-1,-1),0),('BOTTOMPADDING',(0,0),(-1,-1),3),('LEFTPADDING',(0,0),(-1,-1),0),('RIGHTPADDING',(0,0),(-1,-1),0)])) # --- Clinical Features ------------------------------------------ clin_content = [ [sec_title("🩺 CLINICAL FEATURES", bg=ACCENT_RED)], [box([ [cp("<b>Cardiovascular</b>", BOLD_BODY), cp("<b>CNS / Other</b>", BOLD_BODY)], [b("Bradycardia"), b("Altered sensorium")], [b("Hypotension"), b("Seizures (propranolol)")], [b("AV block (I–III°)"), b("Coma")], [b("Wide QRS complex"), b("Bronchospasm")], [b("Cardiogenic shock"), b("Hypoglycaemia")], [b("Asystole"), b("Hypothermia")], ], bg=LIGHT_RED, border=ACCENT_RED, col_widths=[col_w*0.5-4, col_w*0.5-4])], ] clin_table = Table(clin_content, colWidths=[col_w]) clin_table.setStyle(TableStyle([('TOPPADDING',(0,0),(-1,-1),0),('BOTTOMPADDING',(0,0),(-1,-1),3),('LEFTPADDING',(0,0),(-1,-1),0),('RIGHTPADDING',(0,0),(-1,-1),0)])) # --- ECG Changes ------------------------------------------------ ecg_content = [ [sec_title("📈 ECG FINDINGS", bg=colors.HexColor('#6c3483'))], [box([ [b("Sinus bradycardia (most common)")], [b("1st degree AV block → Prolonged PR interval")], [b("Mobitz II / Complete (3rd degree) AV block")], [b("Wide QRS complex (Na⁺ channel blockade)")], [b("Junctional rhythm / Idioventricular rhythm")], [b("VT / VF (sotalol — QT prolongation)")], [b("Asystole in severe overdose")], [Spacer(1,3)], [cp("⚠ Continuous cardiac monitoring is <b>mandatory</b>", WARN)], ], bg=colors.HexColor('#f5eef8'), border=colors.HexColor('#6c3483'))], ] ecg_table = Table(ecg_content, colWidths=[col_w]) ecg_table.setStyle(TableStyle([('TOPPADDING',(0,0),(-1,-1),0),('BOTTOMPADDING',(0,0),(-1,-1),3),('LEFTPADDING',(0,0),(-1,-1),0),('RIGHTPADDING',(0,0),(-1,-1),0)])) col1 = Table([ [pharm_table], [Spacer(1,5)], [clin_table], [Spacer(1,5)], [ecg_table], ], colWidths=[col_w]) col1.setStyle(TableStyle([('TOPPADDING',(0,0),(-1,-1),0),('BOTTOMPADDING',(0,0),(-1,-1),0),('LEFTPADDING',(0,0),(-1,-1),0),('RIGHTPADDING',(0,0),(-1,-1),0)])) # ═══════════════════════════════════════════════════════════════ # COLUMN 2 (stepwise management algorithm) # ═══════════════════════════════════════════════════════════════ def step_box(num, title, items, bg_num=MID_BLUE, bg_box=LIGHT_BG, border=MID_BLUE): num_cell = Table([[cp(str(num), STEP_NUM)]], colWidths=[10*mm]) num_cell.setStyle(TableStyle([ ('BACKGROUND',(0,0),(-1,-1), bg_num), ('TOPPADDING',(0,0),(-1,-1),6),('BOTTOMPADDING',(0,0),(-1,-1),6), ('LEFTPADDING',(0,0),(-1,-1),2),('RIGHTPADDING',(0,0),(-1,-1),2), ('VALIGN',(0,0),(-1,-1),'MIDDLE'), ])) title_cell = Table([[cp(f"<b>{title}</b>", BOX_TITLE_L)]], colWidths=[col_w - 14*mm]) title_cell.setStyle(TableStyle([ ('BACKGROUND',(0,0),(-1,-1), bg_num), ('TOPPADDING',(0,0),(-1,-1),6),('BOTTOMPADDING',(0,0),(-1,-1),6), ('LEFTPADDING',(0,0),(-1,-1),6),('RIGHTPADDING',(0,0),(-1,-1),4), ('VALIGN',(0,0),(-1,-1),'MIDDLE'), ])) header_row = Table([[num_cell, title_cell]], colWidths=[10*mm, col_w - 10*mm]) header_row.setStyle(TableStyle([ ('TOPPADDING',(0,0),(-1,-1),0),('BOTTOMPADDING',(0,0),(-1,-1),0), ('LEFTPADDING',(0,0),(-1,-1),0),('RIGHTPADDING',(0,0),(-1,-1),0), ])) body_rows = [[b(i)] for i in items] body_t = Table(body_rows, colWidths=[col_w]) body_t.setStyle(TableStyle([ ('BACKGROUND',(0,0),(-1,-1), bg_box), ('BOX',(0,0),(-1,-1), 1, border), ('TOPPADDING',(0,0),(-1,-1),3),('BOTTOMPADDING',(0,0),(-1,-1),3), ('LEFTPADDING',(0,0),(-1,-1),7),('RIGHTPADDING',(0,0),(-1,-1),7), ])) outer = Table([[header_row],[body_t]], colWidths=[col_w]) outer.setStyle(TableStyle([ ('TOPPADDING',(0,0),(-1,-1),0),('BOTTOMPADDING',(0,0),(-1,-1),0), ('LEFTPADDING',(0,0),(-1,-1),0),('RIGHTPADDING',(0,0),(-1,-1),0), ])) return outer mgmt_title = Table([[cp("🚨 STEPWISE MANAGEMENT ALGORITHM", BOX_TITLE)]], colWidths=[col_w]) mgmt_title.setStyle(TableStyle([ ('BACKGROUND',(0,0),(-1,-1), DARK_NAVY), ('TOPPADDING',(0,0),(-1,-1),6),('BOTTOMPADDING',(0,0),(-1,-1),6), ('LEFTPADDING',(0,0),(-1,-1),8),('RIGHTPADDING',(0,0),(-1,-1),8), ])) s1 = step_box(1, "IMMEDIATE RESUSCITATION (0–5 min)", [ "ABC — Airway, Breathing, Circulation", "High-flow O₂ / Bag-mask ventilation if needed", "IV access × 2, Cardiac monitor, Pulse oximetry", "12-lead ECG stat — assess QRS, PR, QT", "Point-of-care glucose (hypoglycaemia?)", "Fluid bolus: NS 10–20 mL/kg if hypotensive", ], bg_num=ACCENT_RED, bg_box=LIGHT_RED, border=ACCENT_RED) s2 = step_box(2, "DECONTAMINATION (if ≤ 1–2 hr post-ingestion)", [ "Activated charcoal 1 g/kg PO/NG (if GCS intact, no ileus)", "Gastric lavage: only if large ingestion within 1 hr", "Do NOT induce emesis", "Consider whole bowel irrigation for slow-release formulations", ], bg_num=ACCENT_GOLD, bg_box=LIGHT_GOLD, border=ACCENT_GOLD) s3 = step_box(3, "ATROPINE", [ "0.5–1 mg IV bolus — repeat up to 3 mg total", "Usually insufficient alone for severe toxicity", "Use as bridge while preparing escalation therapy", ], bg_num=colors.HexColor('#1a5276'), bg_box=LIGHT_BG, border=MID_BLUE) s4 = step_box(4, "GLUCAGON (First-line Antidote)", [ "Bolus: 3–10 mg IV over 3–5 minutes", "If response: infusion at 1–5 mg/hr", "Acts via non-adrenergic pathway → ↑ cAMP", "Side effects: vomiting, hyperglycaemia", "Short duration; must follow with HIET if unstable", ], bg_num=ACCENT_TEAL, bg_box=LIGHT_GREEN, border=ACCENT_TEAL) s5 = step_box(5, "HIGH-DOSE INSULIN EUGLYCAEMIA THERAPY (HIET)", [ "Insulin: 1 unit/kg IV bolus → infusion 0.5–1 unit/kg/hr", "Dextrose 50%: 50 mL bolus if glucose < 250 mg/dL", "D10W infusion: 0.5 g/kg/hr to maintain euglycaemia", "Check glucose every 15–30 min", "Potassium monitoring (risk of hypokalaemia)", "Preferred in cardiogenic shock — improves inotropy", ], bg_num=colors.HexColor('#6e2fa1'), bg_box=colors.HexColor('#f5eef8'), border=colors.HexColor('#6c3483')) s6 = step_box(6, "IV LIPID EMULSION (Rescue Therapy)", [ "20% Intralipid: 1.5 mL/kg IV bolus over 1 min", "Repeat bolus × 2 if no response (max 3 boluses)", "Infusion: 0.25–0.5 mL/kg/min for 30–60 min", "Max dose: 10–12 mL/kg total", "Mechanism: 'lipid sink' — sequesters lipophilic drug", "Especially effective for propranolol toxicity", ], bg_num=colors.HexColor('#784212'), bg_box=colors.HexColor('#fdf2e9'), border=colors.HexColor('#784212')) s7 = step_box(7, "PACING / ADVANCED SUPPORT", [ "Transcutaneous pacing if atropine fails", "Transvenous temporary pacemaker for complete AV block", "Vasopressors: Noradrenaline / Adrenaline for refractory shock", "ECMO / IABP: consider in refractory cardiogenic shock", "Haemodialysis: for atenolol, sotalol (hydrophilic agents)", ], bg_num=ACCENT_RED, bg_box=LIGHT_RED, border=ACCENT_RED) col2 = Table([ [mgmt_title], [Spacer(1,4)], [s1],[Spacer(1,3)], [s2],[Spacer(1,3)], [s3],[Spacer(1,3)], [s4],[Spacer(1,3)], [s5],[Spacer(1,3)], [s6],[Spacer(1,3)], [s7], ], colWidths=[col_w]) col2.setStyle(TableStyle([('TOPPADDING',(0,0),(-1,-1),0),('BOTTOMPADDING',(0,0),(-1,-1),0),('LEFTPADDING',(0,0),(-1,-1),0),('RIGHTPADDING',(0,0),(-1,-1),0)])) # ═══════════════════════════════════════════════════════════════ # COLUMN 3 (investigations + special + pitfalls + keywords) # ═══════════════════════════════════════════════════════════════ # Investigations inv_content = [ [sec_title("🔬 INVESTIGATIONS", bg=colors.HexColor('#1a5276'))], [box([ [cp("<b>Bedside</b>", BOLD_BODY), cp("<b>Lab</b>", BOLD_BODY), cp("<b>Imaging</b>", BOLD_BODY)], [b("ECG (stat)"), b("ABG + Lactate"), b("CXR")], [b("POC Glucose"), b("CBC, RFT, LFT"), b("Echo (if shock)")], [b("SpO₂"), b("Serum electrolytes"), b("")], [b("BP (invasive)"), b("Troponin"), b("")], [b(""), b("Serum drug level*"), b("")], [Spacer(1,3), Spacer(1,3), Spacer(1,3)], [cp("*Levels not widely available; clinical diagnosis", SMALL), cp("", SMALL), cp("", SMALL)], ], bg=LIGHT_BG, border=colors.HexColor('#1a5276'), col_widths=[col_w*0.33, col_w*0.37, col_w*0.30])], ] inv_table = Table(inv_content, colWidths=[col_w]) inv_table.setStyle(TableStyle([('TOPPADDING',(0,0),(-1,-1),0),('BOTTOMPADDING',(0,0),(-1,-1),3),('LEFTPADDING',(0,0),(-1,-1),0),('RIGHTPADDING',(0,0),(-1,-1),0)])) # Special populations sp_content = [ [sec_title("⚡ SOTALOL — SPECIAL CONSIDERATION", bg=colors.HexColor('#6c3483'))], [box([ [b("Causes QT prolongation → Torsades de Pointes")], [b("Avoid glucagon (ineffective for K⁺ channel blockade)")], [b("IV Magnesium sulphate 2 g over 10 min for TdP")], [b("Overdrive pacing if recurrent TdP")], [b("Haemodialysis effective (hydrophilic drug)")], [b("Isoproterenol infusion may be considered")], ], bg=colors.HexColor('#f5eef8'), border=colors.HexColor('#6c3483'))], ] sp_table = Table(sp_content, colWidths=[col_w]) sp_table.setStyle(TableStyle([('TOPPADDING',(0,0),(-1,-1),0),('BOTTOMPADDING',(0,0),(-1,-1),3),('LEFTPADDING',(0,0),(-1,-1),0),('RIGHTPADDING',(0,0),(-1,-1),0)])) # Pitfalls pit_content = [ [sec_title("⚠ COMMON PITFALLS", bg=ACCENT_RED)], [box([ [cp("✗ Relying on atropine alone in severe toxicity", WARN)], [cp("✗ Delaying HIET — use early, not as last resort", WARN)], [cp("✗ Missing co-ingestion (CCB + BB = catastrophic)", WARN)], [cp("✗ Discharging early — delayed absorption (SR tabs)", WARN)], [cp("✗ Omitting glucose monitoring during HIET", WARN)], [cp("✗ Using calcium for BB toxicity (ineffective)", WARN)], [Spacer(1,3)], [cp("✓ Calcium IS effective for CCB co-ingestion", GREEN_BOLD)], [cp("✓ HIET works for both BB and CCB toxicity", GREEN_BOLD)], ], bg=LIGHT_RED, border=ACCENT_RED)], ] pit_table = Table(pit_content, colWidths=[col_w]) pit_table.setStyle(TableStyle([('TOPPADDING',(0,0),(-1,-1),0),('BOTTOMPADDING',(0,0),(-1,-1),3),('LEFTPADDING',(0,0),(-1,-1),0),('RIGHTPADDING',(0,0),(-1,-1),0)])) # Disposition disp_content = [ [sec_title("🏥 DISPOSITION", bg=ACCENT_TEAL)], [box([ [cp("<b>ICU/HDU admission for ALL symptomatic patients</b>", BOLD_BODY)], [b("Minimum 6 hrs monitoring for asymptomatic patients")], [b("24 hrs monitoring for modified-release formulations")], [b("Psychiatry consult for intentional overdose")], [b("Poison Control Centre consultation recommended")], ], bg=LIGHT_GREEN, border=ACCENT_TEAL)], ] disp_table = Table(disp_content, colWidths=[col_w]) disp_table.setStyle(TableStyle([('TOPPADDING',(0,0),(-1,-1),0),('BOTTOMPADDING',(0,0),(-1,-1),3),('LEFTPADDING',(0,0),(-1,-1),0),('RIGHTPADDING',(0,0),(-1,-1),0)])) # Treatment ladder summary ladder_content = [ [sec_title("📊 TREATMENT LADDER AT A GLANCE", bg=DARK_NAVY)], [box([ [cp("MILD (brady + hypoTN, responsive)", BOLD_BODY), cp("→ Atropine + Fluids", BODY)], [cp("MODERATE (persistent brady/shock)", BOLD_BODY), cp("→ Glucagon + HIET", BODY)], [cp("SEVERE (refractory shock, AV block)", BOLD_BODY), cp("→ Pacing + Vasopressors + ILE", BODY)], [cp("REFRACTORY (cardiac arrest risk)", BOLD_BODY), cp("→ ECMO / IABP consider", BODY)], ], bg=LIGHT_BG, border=DARK_NAVY, col_widths=[col_w*0.55, col_w*0.45])], ] ladder_table = Table(ladder_content, colWidths=[col_w]) ladder_table.setStyle(TableStyle([('TOPPADDING',(0,0),(-1,-1),0),('BOTTOMPADDING',(0,0),(-1,-1),3),('LEFTPADDING',(0,0),(-1,-1),0),('RIGHTPADDING',(0,0),(-1,-1),0)])) col3 = Table([ [inv_table],[Spacer(1,5)], [sp_table],[Spacer(1,5)], [pit_table],[Spacer(1,5)], [disp_table],[Spacer(1,5)], [ladder_table], ], colWidths=[col_w]) col3.setStyle(TableStyle([('TOPPADDING',(0,0),(-1,-1),0),('BOTTOMPADDING',(0,0),(-1,-1),0),('LEFTPADDING',(0,0),(-1,-1),0),('RIGHTPADDING',(0,0),(-1,-1),0)])) # ─── THREE-COLUMN LAYOUT ────────────────────────────────────── gap = 4*mm main_cols = Table([[col1, Spacer(gap,1), col2, Spacer(gap,1), col3]], colWidths=[col_w, gap, col_w, gap, col_w]) main_cols.setStyle(TableStyle([ ('TOPPADDING',(0,0),(-1,-1),0),('BOTTOMPADDING',(0,0),(-1,-1),0), ('LEFTPADDING',(0,0),(-1,-1),0),('RIGHTPADDING',(0,0),(-1,-1),0), ('VALIGN',(0,0),(-1,-1),'TOP'), ])) # ─── FOOTER ─────────────────────────────────────────────────── footer_data = [[ cp("Keywords: Beta blocker toxicity • Bradycardia • Glucagon • HIET • Lipid emulsion • AV block • Emergency Department • Atenolol • Amlodipine • Cardiac poisoning", KEYWORD_S), cp("Dept. of Emergency Medicine | Smt. NHL Medical College, Ahmedabad | 2026", KEYWORD_S), ]] footer_table = Table(footer_data, colWidths=[W*0.65, W*0.35]) footer_table.setStyle(TableStyle([ ('BACKGROUND',(0,0),(-1,-1), DARK_NAVY), ('TOPPADDING',(0,0),(-1,-1),6),('BOTTOMPADDING',(0,0),(-1,-1),6), ('LEFTPADDING',(0,0),(-1,-1),10),('RIGHTPADDING',(0,0),(-1,-1),10), ('TEXTCOLOR',(0,0),(-1,-1), WHITE), ])) # ─── BUILD DOCUMENT ─────────────────────────────────────────── story = [ header_table, subheader_table, inst_table, Spacer(1, 5), main_cols, Spacer(1, 6), footer_table, ] doc.build(story) print(f"Poster PDF created: {output_path}") EOF

python3 << 'EOF' import os os.makedirs("/tmp/workspace/nayan-abstract", exist_ok=True) from reportlab.lib.pagesizes import A3, landscape from reportlab.lib import colors from reportlab.lib.units import mm, cm from reportlab.lib.styles import getSampleStyleSheet, ParagraphStyle from reportlab.lib.enums import TA_CENTER, TA_LEFT, TA_JUSTIFY from reportlab.platypus import SimpleDocTemplate, Paragraph, Spacer, HRFlowable, Table, TableStyle output_path = "/tmp/workspace/nayan-abstract/BetaBlocker_Toxicity_Management_Poster.pdf" doc = SimpleDocTemplate( output_path, pagesize=landscape(A3), rightMargin=1.5*cm, leftMargin=1.5*cm, topMargin=1.5*cm, bottomMargin=1.5*cm, ) W = landscape(A3)[0] - 3*cm DARK_NAVY = colors.HexColor('#0d1b2a') MID_BLUE = colors.HexColor('#1b4f72') ACCENT_RED = colors.HexColor('#c0392b') ACCENT_TEAL = colors.HexColor('#148f77') ACCENT_GOLD = colors.HexColor('#b7950b') LIGHT_BG = colors.HexColor('#eaf4fb') LIGHT_RED = colors.HexColor('#fdedec') LIGHT_GREEN = colors.HexColor('#eafaf1') LIGHT_GOLD = colors.HexColor('#fef9e7') WHITE = colors.white GREY_TEXT = colors.HexColor('#2c3e50') PURPLE = colors.HexColor('#6c3483') LIGHT_PURPLE= colors.HexColor('#f5eef8') BROWN = colors.HexColor('#784212') LIGHT_BROWN = colors.HexColor('#fdf2e9') DARK_BLUE2 = colors.HexColor('#1a5276') def S(name, **kw): return ParagraphStyle(name, fontName='Helvetica', fontSize=9, textColor=GREY_TEXT, leading=13, spaceAfter=2, **kw) MAIN_TITLE = S('mt', fontSize=20, fontName='Helvetica-Bold', textColor=WHITE, alignment=TA_CENTER, leading=26) SUB_TITLE = S('st', fontSize=10, fontName='Helvetica', textColor=colors.HexColor('#d6eaf8'), alignment=TA_CENTER, leading=14) INST_STYLE = S('inst', fontSize=8.5, fontName='Helvetica', textColor=colors.HexColor('#aed6f1'), alignment=TA_CENTER, leading=12) BOX_TITLE = S('bt', fontSize=10.5, fontName='Helvetica-Bold', textColor=WHITE, alignment=TA_CENTER, leading=14) BOX_TITLE_L = S('btl', fontSize=10.5, fontName='Helvetica-Bold', textColor=WHITE, alignment=TA_LEFT, leading=14) BODY = S('body', fontSize=8.5, leading=13, alignment=TA_LEFT, textColor=GREY_TEXT) BODY_C = S('bodyc', fontSize=8.5, leading=13, alignment=TA_CENTER, textColor=GREY_TEXT) BOLD_BODY = S('bb', fontSize=8.5, fontName='Helvetica-Bold', leading=13, textColor=GREY_TEXT) SMALL = S('sm', fontSize=7.5, leading=11, textColor=colors.HexColor('#666666')) STEP_NUM = S('sn', fontSize=14, fontName='Helvetica-Bold', textColor=WHITE, alignment=TA_CENTER, leading=18) WARN = S('warn', fontSize=8.5, fontName='Helvetica-Bold', textColor=ACCENT_RED, leading=13) GREEN_BOLD = S('gb', fontSize=8.5, fontName='Helvetica-Bold', textColor=ACCENT_TEAL, leading=13) KEYWORD_S = S('kw', fontSize=7.5, textColor=WHITE, alignment=TA_CENTER, leading=11) def cp(text, style): return Paragraph(text, style) def b(text, bold=False, color=None): st = BOLD_BODY if bold else BODY if color: st = ParagraphStyle('tmp', parent=st, textColor=color) return cp(f"• {text}", st) def sec_title(text, bg=MID_BLUE): t = Table([[cp(text, BOX_TITLE)]], colWidths=['100%']) 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), ])) return t def wbox(rows, bg=LIGHT_BG, border=MID_BLUE, cw=None): if cw is None: cw=['100%'] t = Table(rows, colWidths=cw) t.setStyle(TableStyle([ ('BACKGROUND',(0,0),(-1,-1),bg), ('BOX',(0,0),(-1,-1),1,border), ('TOPPADDING',(0,0),(-1,-1),3),('BOTTOMPADDING',(0,0),(-1,-1),3), ('LEFTPADDING',(0,0),(-1,-1),7),('RIGHTPADDING',(0,0),(-1,-1),7), ('VALIGN',(0,0),(-1,-1),'TOP'), ])) return t def zero_pad(t): t.setStyle(TableStyle([('TOPPADDING',(0,0),(-1,-1),0),('BOTTOMPADDING',(0,0),(-1,-1),0), ('LEFTPADDING',(0,0),(-1,-1),0),('RIGHTPADDING',(0,0),(-1,-1),0)])) return t col_w = W / 3 - 4*mm # ═══ COLUMN 1 ═══ pharm = zero_pad(Table([ [sec_title("PHARMACOLOGY & MECHANISM", bg=DARK_NAVY)], [wbox([ [cp("<b>Beta-1 (cardiac):</b> SA node, AV node, myocardium", BODY)], [cp("<b>Beta-2 (peripheral):</b> Bronchi, vasculature, liver", BODY)], [Spacer(1,3)], [cp("<b>Mechanism of Toxicity:</b>", BOLD_BODY)], [b("Competitive blockade of beta-adrenergic receptors")], [b("Decrease in cAMP -> decrease in Ca2+ entry -> myocardial depression")], [b("Bradycardia, decreased inotropy, decreased chronotropy")], [b("Propranolol: Na+ channel blockade -> QRS widening")], [b("Non-selective agents -> hypoglycaemia")], [Spacer(1,3)], [cp("<b>Lipophilic (cross BBB):</b> Propranolol, metoprolol, labetalol", BODY)], [cp("<b>Hydrophilic:</b> Atenolol, sotalol", BODY)], ], bg=LIGHT_BG)], ], colWidths=[col_w])) clin = zero_pad(Table([ [sec_title("CLINICAL FEATURES", bg=ACCENT_RED)], [wbox([ [cp("<b>Cardiovascular</b>", BOLD_BODY), cp("<b>CNS / Other</b>", BOLD_BODY)], [b("Bradycardia"), b("Altered sensorium")], [b("Hypotension"), b("Seizures (propranolol)")], [b("AV block (I-III degrees)"), b("Coma")], [b("Wide QRS"), b("Bronchospasm")], [b("Cardiogenic shock"), b("Hypoglycaemia")], [b("Asystole"), b("Hypothermia")], ], bg=LIGHT_RED, border=ACCENT_RED, cw=[col_w*0.5-4, col_w*0.5-4])], ], colWidths=[col_w])) ecg = zero_pad(Table([ [sec_title("ECG FINDINGS", bg=PURPLE)], [wbox([ [b("Sinus bradycardia (most common)")], [b("1st degree AV block - Prolonged PR interval")], [b("Mobitz II / Complete (3rd degree) AV block")], [b("Wide QRS complex (Na+ channel blockade)")], [b("Junctional or Idioventricular rhythm")], [b("VT/VF - sotalol causes QT prolongation")], [b("Asystole in severe overdose")], [Spacer(1,3)], [cp("Continuous cardiac monitoring is MANDATORY", WARN)], ], bg=LIGHT_PURPLE, border=PURPLE)], ], colWidths=[col_w])) col1 = zero_pad(Table([[pharm],[Spacer(1,5)],[clin],[Spacer(1,5)],[ecg]], colWidths=[col_w])) # ═══ COLUMN 2 ═══ def step_box(num, title, items, c_num=MID_BLUE, c_box=LIGHT_BG, c_bdr=MID_BLUE): num_t = Table([[cp(str(num), STEP_NUM)]], colWidths=[10*mm]) num_t.setStyle(TableStyle([('BACKGROUND',(0,0),(-1,-1),c_num),('TOPPADDING',(0,0),(-1,-1),5),('BOTTOMPADDING',(0,0),(-1,-1),5),('LEFTPADDING',(0,0),(-1,-1),2),('RIGHTPADDING',(0,0),(-1,-1),2),('VALIGN',(0,0),(-1,-1),'MIDDLE')])) ttl_t = Table([[cp(f"<b>{title}</b>", BOX_TITLE_L)]], colWidths=[col_w-10*mm]) ttl_t.setStyle(TableStyle([('BACKGROUND',(0,0),(-1,-1),c_num),('TOPPADDING',(0,0),(-1,-1),5),('BOTTOMPADDING',(0,0),(-1,-1),5),('LEFTPADDING',(0,0),(-1,-1),6),('RIGHTPADDING',(0,0),(-1,-1),4),('VALIGN',(0,0),(-1,-1),'MIDDLE')])) hdr = zero_pad(Table([[num_t, ttl_t]], colWidths=[10*mm, col_w-10*mm])) bdy = Table([[b(i)] for i in items], colWidths=[col_w]) bdy.setStyle(TableStyle([('BACKGROUND',(0,0),(-1,-1),c_box),('BOX',(0,0),(-1,-1),1,c_bdr),('TOPPADDING',(0,0),(-1,-1),3),('BOTTOMPADDING',(0,0),(-1,-1),3),('LEFTPADDING',(0,0),(-1,-1),7),('RIGHTPADDING',(0,0),(-1,-1),7)])) return zero_pad(Table([[hdr],[bdy]], colWidths=[col_w])) mgmt_hdr = Table([[cp("STEPWISE MANAGEMENT ALGORITHM", BOX_TITLE)]], colWidths=[col_w]) mgmt_hdr.setStyle(TableStyle([('BACKGROUND',(0,0),(-1,-1),DARK_NAVY),('TOPPADDING',(0,0),(-1,-1),6),('BOTTOMPADDING',(0,0),(-1,-1),6),('LEFTPADDING',(0,0),(-1,-1),8),('RIGHTPADDING',(0,0),(-1,-1),8)])) s1 = step_box(1,"IMMEDIATE RESUSCITATION (0-5 min)",["ABC - Airway, Breathing, Circulation","High-flow O2 / Bag-mask ventilation if needed","IV access x2, Cardiac monitor, Pulse oximetry","12-lead ECG stat - assess QRS, PR, QT intervals","Point-of-care glucose (rule out hypoglycaemia)","NS fluid bolus 10-20 mL/kg if hypotensive"],c_num=ACCENT_RED,c_box=LIGHT_RED,c_bdr=ACCENT_RED) s2 = step_box(2,"DECONTAMINATION (if within 1-2 hrs)",["Activated charcoal 1 g/kg PO/NG (if GCS intact)","Gastric lavage: large ingestion within 1 hour only","Do NOT induce emesis","Whole bowel irrigation for slow-release formulations"],c_num=ACCENT_GOLD,c_box=LIGHT_GOLD,c_bdr=ACCENT_GOLD) s3 = step_box(3,"ATROPINE",["0.5-1 mg IV bolus, repeat up to 3 mg total","Usually insufficient alone in severe toxicity","Use as bridge while preparing escalation therapy"],c_num=DARK_BLUE2,c_box=LIGHT_BG,c_bdr=MID_BLUE) s4 = step_box(4,"GLUCAGON - First-line Antidote",["Bolus: 3-10 mg IV over 3-5 minutes","Infusion: 1-5 mg/hr if response achieved","Acts via non-adrenergic pathway -> increases cAMP","Side effects: vomiting, hyperglycaemia","Short duration - must escalate to HIET if still unstable"],c_num=ACCENT_TEAL,c_box=LIGHT_GREEN,c_bdr=ACCENT_TEAL) s5 = step_box(5,"HIGH-DOSE INSULIN EUGLYCAEMIA THERAPY (HIET)",["Insulin: 1 unit/kg IV bolus -> 0.5-1 unit/kg/hr infusion","Dextrose 50%: 50 mL bolus if glucose < 250 mg/dL","D10W infusion: 0.5 g/kg/hr to maintain euglycaemia","Check blood glucose every 15-30 minutes","Monitor potassium (risk of hypokalaemia)","Preferred agent in cardiogenic shock - improves inotropy"],c_num=PURPLE,c_box=LIGHT_PURPLE,c_bdr=PURPLE) s6 = step_box(6,"IV LIPID EMULSION - Rescue Therapy",["20% Intralipid: 1.5 mL/kg IV bolus over 1 minute","Repeat bolus x2 if no response (max 3 boluses)","Infusion: 0.25-0.5 mL/kg/min for 30-60 minutes","Maximum dose: 10-12 mL/kg total","Mechanism: lipid sink sequesters lipophilic drug","Most effective for propranolol toxicity"],c_num=BROWN,c_box=LIGHT_BROWN,c_bdr=BROWN) s7 = step_box(7,"PACING / ADVANCED SUPPORT",["Transcutaneous pacing if atropine fails","Transvenous temporary pacemaker for complete AV block","Vasopressors: Noradrenaline / Adrenaline for refractory shock","ECMO / IABP: consider in refractory cardiogenic shock","Haemodialysis: atenolol, sotalol (hydrophilic agents)"],c_num=ACCENT_RED,c_box=LIGHT_RED,c_bdr=ACCENT_RED) col2 = zero_pad(Table([[mgmt_hdr],[Spacer(1,4)],[s1],[Spacer(1,3)],[s2],[Spacer(1,3)],[s3],[Spacer(1,3)],[s4],[Spacer(1,3)],[s5],[Spacer(1,3)],[s6],[Spacer(1,3)],[s7]], colWidths=[col_w])) # ═══ COLUMN 3 ═══ inv = zero_pad(Table([ [sec_title("INVESTIGATIONS", bg=DARK_BLUE2)], [wbox([ [cp("<b>Bedside</b>",BOLD_BODY),cp("<b>Laboratory</b>",BOLD_BODY),cp("<b>Imaging</b>",BOLD_BODY)], [b("ECG (stat)"),b("ABG + Lactate"),b("CXR")], [b("POC Glucose"),b("CBC, RFT, LFT"),b("Echo if shock")], [b("SpO2"),b("Serum electrolytes"),b("")], [b("NIBP / IBP"),b("Troponin I"),b("")], [b(""),b("Serum drug level*"),b("")], [Spacer(1,2),Spacer(1,2),Spacer(1,2)], [cp("*Levels not widely available; diagnosis is clinical",SMALL),cp("",SMALL),cp("",SMALL)], ],bg=LIGHT_BG,border=DARK_BLUE2,cw=[col_w*0.32,col_w*0.38,col_w*0.30])], ], colWidths=[col_w])) sotalol = zero_pad(Table([ [sec_title("SOTALOL - SPECIAL CONSIDERATION", bg=PURPLE)], [wbox([ [b("Causes QT prolongation -> Torsades de Pointes (TdP)")], [b("Glucagon less effective (K+ channel blockade mechanism)")], [b("IV Magnesium sulphate 2 g over 10 min for TdP")], [b("Overdrive pacing if TdP is recurrent")], [b("Haemodialysis effective (hydrophilic agent)")], [b("Isoproterenol infusion may be considered")], ],bg=LIGHT_PURPLE,border=PURPLE)], ], colWidths=[col_w])) pitfalls = zero_pad(Table([ [sec_title("COMMON PITFALLS", bg=ACCENT_RED)], [wbox([ [cp("X Relying on atropine alone in severe toxicity",WARN)], [cp("X Delaying HIET - use early, not as last resort",WARN)], [cp("X Missing co-ingestion (CCB + BB = catastrophic)",WARN)], [cp("X Early discharge - delayed absorption with SR tablets",WARN)], [cp("X Omitting glucose monitoring during HIET",WARN)], [cp("X Using calcium for BB toxicity alone (ineffective)",WARN)], [Spacer(1,3)], [cp("CORRECT: Calcium IS effective for CCB co-ingestion",GREEN_BOLD)], [cp("CORRECT: HIET works for both BB and CCB toxicity",GREEN_BOLD)], ],bg=LIGHT_RED,border=ACCENT_RED)], ], colWidths=[col_w])) disp = zero_pad(Table([ [sec_title("DISPOSITION", bg=ACCENT_TEAL)], [wbox([ [cp("<b>ICU/HDU admission for ALL symptomatic patients</b>",BOLD_BODY)], [b("Minimum 6 hours monitoring for asymptomatic patients")], [b("24 hours monitoring for modified-release formulations")], [b("Psychiatry consult for intentional self-harm overdose")], [b("Poison Control Centre consultation recommended")], ],bg=LIGHT_GREEN,border=ACCENT_TEAL)], ], colWidths=[col_w])) ladder = zero_pad(Table([ [sec_title("TREATMENT LADDER SUMMARY", bg=DARK_NAVY)], [wbox([ [cp("MILD (bradycardia + hypotension, responsive)",BOLD_BODY),cp("-> Atropine + Fluids",BODY)], [cp("MODERATE (persistent bradycardia/shock)",BOLD_BODY),cp("-> Glucagon + HIET",BODY)], [cp("SEVERE (refractory shock, AV block)",BOLD_BODY),cp("-> Pacing + Vasopressors + ILE",BODY)], [cp("REFRACTORY (cardiac arrest risk)",BOLD_BODY),cp("-> ECMO / IABP consider",BODY)], ],bg=LIGHT_BG,border=DARK_NAVY,cw=[col_w*0.56, col_w*0.44])], ], colWidths=[col_w])) col3 = zero_pad(Table([[inv],[Spacer(1,5)],[sotalol],[Spacer(1,5)],[pitfalls],[Spacer(1,5)],[disp],[Spacer(1,5)],[ladder]], colWidths=[col_w])) # ─── HEADER ─────────────────────────────────────────────────── hdr1 = Table([[cp("BETA BLOCKER TOXICITY: EMERGENCY MANAGEMENT GUIDE", MAIN_TITLE)]], colWidths=[W]) hdr1.setStyle(TableStyle([('BACKGROUND',(0,0),(-1,-1),DARK_NAVY),('TOPPADDING',(0,0),(-1,-1),10),('BOTTOMPADDING',(0,0),(-1,-1),6),('LEFTPADDING',(0,0),(-1,-1),8),('RIGHTPADDING',(0,0),(-1,-1),8)])) hdr2 = Table([[cp("Dr. Nayan Lakhmanbhai Varu | Guide: Dr. Bhavesh Jarwani | Co-Guide: Dr. Dharmishtra Dhusha", SUB_TITLE)]], colWidths=[W]) hdr2.setStyle(TableStyle([('BACKGROUND',(0,0),(-1,-1),MID_BLUE),('TOPPADDING',(0,0),(-1,-1),5),('BOTTOMPADDING',(0,0),(-1,-1),5),('LEFTPADDING',(0,0),(-1,-1),8),('RIGHTPADDING',(0,0),(-1,-1),8)])) hdr3 = Table([[cp("2nd Year Emergency Medicine Resident | Dept. of Emergency Medicine, Smt. NHL Medical College, Ahmedabad", INST_STYLE)]], colWidths=[W]) hdr3.setStyle(TableStyle([('BACKGROUND',(0,0),(-1,-1),colors.HexColor('#154360')),('TOPPADDING',(0,0),(-1,-1),4),('BOTTOMPADDING',(0,0),(-1,-1),5),('LEFTPADDING',(0,0),(-1,-1),8),('RIGHTPADDING',(0,0),(-1,-1),8)])) # ─── MAIN GRID ──────────────────────────────────────────────── gap = 5*mm main = Table([[col1, Spacer(gap,1), col2, Spacer(gap,1), col3]], colWidths=[col_w,gap,col_w,gap,col_w]) main.setStyle(TableStyle([('TOPPADDING',(0,0),(-1,-1),0),('BOTTOMPADDING',(0,0),(-1,-1),0),('LEFTPADDING',(0,0),(-1,-1),0),('RIGHTPADDING',(0,0),(-1,-1),0),('VALIGN',(0,0),(-1,-1),'TOP')])) # ─── FOOTER ─────────────────────────────────────────────────── ftr = Table([[ cp("Keywords: Beta blocker toxicity • Bradycardia • Glucagon • HIET • Lipid emulsion • AV block • Emergency Department • Atenolol • Amlodipine • Cardiac poisoning", KEYWORD_S), cp("Dept. of Emergency Medicine | Smt. NHL Medical College, Ahmedabad | 2026", KEYWORD_S), ]], colWidths=[W*0.65, W*0.35]) ftr.setStyle(TableStyle([('BACKGROUND',(0,0),(-1,-1),DARK_NAVY),('TOPPADDING',(0,0),(-1,-1),6),('BOTTOMPADDING',(0,0),(-1,-1),6),('LEFTPADDING',(0,0),(-1,-1),10),('RIGHTPADDING',(0,0),(-1,-1),10)])) story = [hdr1, hdr2, hdr3, Spacer(1,5), main, Spacer(1,6), ftr] doc.build(story) print("SUCCESS:", output_path) EOF

python3 << 'PYEOF' import os os.makedirs("/tmp/workspace/nayan-abstract", exist_ok=True) from reportlab.lib.pagesizes import A3, landscape from reportlab.lib import colors from reportlab.lib.units import mm, cm from reportlab.lib.styles import ParagraphStyle from reportlab.lib.enums import TA_CENTER, TA_LEFT from reportlab.platypus import SimpleDocTemplate, Paragraph, Spacer, Table, TableStyle output_path = "/tmp/workspace/nayan-abstract/BetaBlocker_Toxicity_Management_Poster.pdf" doc = SimpleDocTemplate(output_path, pagesize=landscape(A3), rightMargin=1.5*cm, leftMargin=1.5*cm, topMargin=1.5*cm, bottomMargin=1.5*cm) W = landscape(A3)[0] - 3*cm # Colours DARK_NAVY = colors.HexColor('#0d1b2a') MID_BLUE = colors.HexColor('#1b4f72') RED = colors.HexColor('#c0392b') TEAL = colors.HexColor('#148f77') GOLD = colors.HexColor('#b7950b') PURPLE = colors.HexColor('#6c3483') BROWN = colors.HexColor('#784212') DARK_BLUE2 = colors.HexColor('#1a5276') L_BLUE = colors.HexColor('#eaf4fb') L_RED = colors.HexColor('#fdedec') L_GREEN = colors.HexColor('#eafaf1') L_GOLD = colors.HexColor('#fef9e7') L_PURPLE = colors.HexColor('#f5eef8') L_BROWN = colors.HexColor('#fdf2e9') WHITE = colors.white GREY = colors.HexColor('#2c3e50') # Styles — build each individually to avoid duplicate-kwarg issue def mk(name, fn='Helvetica', fs=9, tc=GREY, al=TA_LEFT, ld=13, sa=2, sb=0, bold=False): return ParagraphStyle(name, fontName=fn, fontSize=fs, textColor=tc, alignment=al, leading=ld, spaceAfter=sa, spaceBefore=sb) MAIN_TITLE = mk('mt','Helvetica-Bold',20,WHITE,TA_CENTER,26) SUB_TITLE = mk('st','Helvetica',10,colors.HexColor('#d6eaf8'),TA_CENTER,14) INST_STY = mk('is','Helvetica',8.5,colors.HexColor('#aed6f1'),TA_CENTER,12) BOX_TITLE = mk('bth','Helvetica-Bold',10.5,WHITE,TA_CENTER,14) BOX_TITLE_L= mk('btl','Helvetica-Bold',10.5,WHITE,TA_LEFT,14) BODY = mk('bd','Helvetica',8.5,GREY,TA_LEFT,13) BOLD_BODY = mk('bbd','Helvetica-Bold',8.5,GREY,TA_LEFT,13) SMALL = mk('sm','Helvetica',7.5,colors.HexColor('#666666'),TA_LEFT,11) STEP_NUM = mk('sn','Helvetica-Bold',14,WHITE,TA_CENTER,18) WARN = mk('wn','Helvetica-Bold',8.5,RED,TA_LEFT,13) GREEN_BOLD = mk('gb','Helvetica-Bold',8.5,TEAL,TA_LEFT,13) KEYWORD_S = mk('kw','Helvetica',7.5,WHITE,TA_CENTER,11) def cp(text, sty): return Paragraph(text, sty) def b(text): return cp(f"• {text}", BODY) def bb(text): return cp(f"• {text}", BOLD_BODY) def zero(t): t.setStyle(TableStyle([('TOPPADDING',(0,0),(-1,-1),0),('BOTTOMPADDING',(0,0),(-1,-1),0), ('LEFTPADDING',(0,0),(-1,-1),0),('RIGHTPADDING',(0,0),(-1,-1),0)])) return t def sec_hdr(text, bg=MID_BLUE): t = Table([[cp(text, BOX_TITLE)]], colWidths=['100%']) 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)])) return t def wbox(rows, bg=L_BLUE, border=MID_BLUE, cw=None): t = Table(rows, colWidths=cw) t.setStyle(TableStyle([('BACKGROUND',(0,0),(-1,-1),bg), ('BOX',(0,0),(-1,-1),1,border), ('TOPPADDING',(0,0),(-1,-1),3),('BOTTOMPADDING',(0,0),(-1,-1),3), ('LEFTPADDING',(0,0),(-1,-1),7),('RIGHTPADDING',(0,0),(-1,-1),7), ('VALIGN',(0,0),(-1,-1),'TOP')])) return t col_w = W / 3 - 4*mm # ══ COL 1 ══ pharm = zero(Table([ [sec_hdr("PHARMACOLOGY & MECHANISM", DARK_NAVY)], [wbox([[cp("<b>Beta-1 (cardiac):</b> SA node, AV node, myocardium", BODY)], [cp("<b>Beta-2 (peripheral):</b> Bronchi, vasculature, liver", BODY)], [Spacer(1,3)], [cp("<b>Mechanism of Toxicity:</b>", BOLD_BODY)], [b("Competitive blockade of beta-adrenergic receptors")], [b("Decreased cAMP -> decreased Ca2+ entry -> myocardial depression")], [b("Bradycardia, reduced inotropy and chronotropy")], [b("Propranolol: Na+ channel blockade -> QRS widening")], [b("Non-selective agents -> hypoglycaemia")], [Spacer(1,3)], [cp("<b>Lipophilic (cross BBB):</b> Propranolol, metoprolol, labetalol", BODY)], [cp("<b>Hydrophilic:</b> Atenolol, sotalol", BODY)]], bg=L_BLUE)], ], colWidths=[col_w])) clin = zero(Table([ [sec_hdr("CLINICAL FEATURES", RED)], [wbox([[cp("<b>Cardiovascular</b>", BOLD_BODY), cp("<b>CNS / Other</b>", BOLD_BODY)], [b("Bradycardia"), b("Altered sensorium")], [b("Hypotension"), b("Seizures (propranolol)")], [b("AV block I-III degrees"), b("Coma")], [b("Wide QRS complex"), b("Bronchospasm")], [b("Cardiogenic shock"), b("Hypoglycaemia")], [b("Asystole"), b("Hypothermia")]], bg=L_RED, border=RED, cw=[col_w*0.5-4, col_w*0.5-4])], ], colWidths=[col_w])) ecg = zero(Table([ [sec_hdr("ECG FINDINGS", PURPLE)], [wbox([[b("Sinus bradycardia (most common)")], [b("1st degree AV block - prolonged PR interval")], [b("Mobitz II / Complete (3rd degree) AV block")], [b("Wide QRS complex (Na+ channel blockade)")], [b("Junctional or idioventricular rhythm")], [b("VT/VF - sotalol causes QT prolongation")], [b("Asystole in severe overdose")], [Spacer(1,3)], [cp("Continuous cardiac monitoring is MANDATORY", WARN)]], bg=L_PURPLE, border=PURPLE)], ], colWidths=[col_w])) col1 = zero(Table([[pharm],[Spacer(1,5)],[clin],[Spacer(1,5)],[ecg]], colWidths=[col_w])) # ══ COL 2 - step boxes ══ def step_box(num, title, items, cn=MID_BLUE, cb=L_BLUE, cd=MID_BLUE): nt = Table([[cp(str(num), STEP_NUM)]], colWidths=[10*mm]) nt.setStyle(TableStyle([('BACKGROUND',(0,0),(-1,-1),cn), ('TOPPADDING',(0,0),(-1,-1),5),('BOTTOMPADDING',(0,0),(-1,-1),5), ('LEFTPADDING',(0,0),(-1,-1),2),('RIGHTPADDING',(0,0),(-1,-1),2), ('VALIGN',(0,0),(-1,-1),'MIDDLE')])) tt = Table([[cp(f"<b>{title}</b>", BOX_TITLE_L)]], colWidths=[col_w-10*mm]) tt.setStyle(TableStyle([('BACKGROUND',(0,0),(-1,-1),cn), ('TOPPADDING',(0,0),(-1,-1),5),('BOTTOMPADDING',(0,0),(-1,-1),5), ('LEFTPADDING',(0,0),(-1,-1),6),('RIGHTPADDING',(0,0),(-1,-1),4), ('VALIGN',(0,0),(-1,-1),'MIDDLE')])) hdr = zero(Table([[nt, tt]], colWidths=[10*mm, col_w-10*mm])) bdy = Table([[b(i)] for i in items], colWidths=[col_w]) bdy.setStyle(TableStyle([('BACKGROUND',(0,0),(-1,-1),cb), ('BOX',(0,0),(-1,-1),1,cd), ('TOPPADDING',(0,0),(-1,-1),3),('BOTTOMPADDING',(0,0),(-1,-1),3), ('LEFTPADDING',(0,0),(-1,-1),7),('RIGHTPADDING',(0,0),(-1,-1),7)])) return zero(Table([[hdr],[bdy]], colWidths=[col_w])) mh = Table([[cp("STEPWISE MANAGEMENT ALGORITHM", BOX_TITLE)]], colWidths=[col_w]) mh.setStyle(TableStyle([('BACKGROUND',(0,0),(-1,-1),DARK_NAVY), ('TOPPADDING',(0,0),(-1,-1),6),('BOTTOMPADDING',(0,0),(-1,-1),6), ('LEFTPADDING',(0,0),(-1,-1),8),('RIGHTPADDING',(0,0),(-1,-1),8)])) s1 = step_box(1,"IMMEDIATE RESUSCITATION (0-5 min)", ["ABC - Airway, Breathing, Circulation","High-flow O2 / Bag-mask ventilation if needed", "IV access x2, Cardiac monitor, Pulse oximetry","12-lead ECG stat - assess QRS, PR, QT intervals", "Point-of-care glucose (rule out hypoglycaemia)","NS fluid bolus 10-20 mL/kg if hypotensive"], cn=RED,cb=L_RED,cd=RED) s2 = step_box(2,"DECONTAMINATION (if within 1-2 hrs)", ["Activated charcoal 1 g/kg PO/NG (if GCS intact)","Gastric lavage: large ingestion within 1 hour only", "Do NOT induce emesis","Whole bowel irrigation for slow-release formulations"], cn=GOLD,cb=L_GOLD,cd=GOLD) s3 = step_box(3,"ATROPINE", ["0.5-1 mg IV bolus, repeat up to 3 mg total","Usually insufficient alone in severe toxicity", "Use as bridge while preparing escalation therapy"], cn=DARK_BLUE2,cb=L_BLUE,cd=MID_BLUE) s4 = step_box(4,"GLUCAGON - First-line Antidote", ["Bolus: 3-10 mg IV over 3-5 minutes","Infusion: 1-5 mg/hr if response achieved", "Acts via non-adrenergic pathway - increases cAMP","Side effects: vomiting, hyperglycaemia", "Short duration - must escalate to HIET if still unstable"], cn=TEAL,cb=L_GREEN,cd=TEAL) s5 = step_box(5,"HIGH-DOSE INSULIN EUGLYCAEMIA THERAPY (HIET)", ["Insulin: 1 unit/kg IV bolus -> 0.5-1 unit/kg/hr infusion", "Dextrose 50%: 50 mL bolus if glucose < 250 mg/dL", "D10W infusion: 0.5 g/kg/hr to maintain euglycaemia", "Check blood glucose every 15-30 minutes","Monitor potassium (risk of hypokalaemia)", "Preferred in cardiogenic shock - improves inotropy"], cn=PURPLE,cb=L_PURPLE,cd=PURPLE) s6 = step_box(6,"IV LIPID EMULSION - Rescue Therapy", ["20% Intralipid: 1.5 mL/kg IV bolus over 1 minute","Repeat bolus x2 if no response (max 3 boluses)", "Infusion: 0.25-0.5 mL/kg/min for 30-60 minutes","Maximum dose: 10-12 mL/kg total", "Mechanism: lipid sink sequesters lipophilic drug","Most effective for propranolol toxicity"], cn=BROWN,cb=L_BROWN,cd=BROWN) s7 = step_box(7,"PACING / ADVANCED SUPPORT", ["Transcutaneous pacing if atropine fails","Transvenous temporary pacemaker for complete AV block", "Vasopressors: Noradrenaline/Adrenaline for refractory shock", "ECMO / IABP: consider in refractory cardiogenic shock", "Haemodialysis: atenolol, sotalol (hydrophilic agents)"], cn=RED,cb=L_RED,cd=RED) col2 = zero(Table([[mh],[Spacer(1,4)], [s1],[Spacer(1,3)],[s2],[Spacer(1,3)],[s3],[Spacer(1,3)], [s4],[Spacer(1,3)],[s5],[Spacer(1,3)],[s6],[Spacer(1,3)],[s7]], colWidths=[col_w])) # ══ COL 3 ══ inv = zero(Table([ [sec_hdr("INVESTIGATIONS", DARK_BLUE2)], [wbox([[cp("<b>Bedside</b>",BOLD_BODY),cp("<b>Laboratory</b>",BOLD_BODY),cp("<b>Imaging</b>",BOLD_BODY)], [b("ECG (stat)"),b("ABG + Lactate"),b("CXR")], [b("POC Glucose"),b("CBC, RFT, LFT"),b("Echo if shock")], [b("SpO2"),b("Serum electrolytes"),b("")], [b("NIBP / IBP"),b("Troponin I"),b("")], [b(""),b("Serum drug level*"),b("")], [Spacer(1,2),Spacer(1,2),Spacer(1,2)], [cp("*Levels not widely available; diagnosis is clinical",SMALL),cp("",SMALL),cp("",SMALL)]], bg=L_BLUE,border=DARK_BLUE2,cw=[col_w*0.32,col_w*0.38,col_w*0.30])], ], colWidths=[col_w])) sotalol = zero(Table([ [sec_hdr("SOTALOL - SPECIAL CONSIDERATION", PURPLE)], [wbox([[b("Causes QT prolongation -> Torsades de Pointes (TdP)")], [b("Glucagon less effective (K+ channel blockade mechanism)")], [b("IV Magnesium sulphate 2 g over 10 min for TdP")], [b("Overdrive pacing if TdP is recurrent")], [b("Haemodialysis effective (hydrophilic agent)")], [b("Isoproterenol infusion may be considered")]], bg=L_PURPLE,border=PURPLE)], ], colWidths=[col_w])) pitfalls = zero(Table([ [sec_hdr("COMMON PITFALLS", RED)], [wbox([[cp("X Relying on atropine alone in severe toxicity", WARN)], [cp("X Delaying HIET - use early, not as last resort", WARN)], [cp("X Missing co-ingestion: CCB + BB is catastrophic", WARN)], [cp("X Early discharge - delayed absorption with SR tablets", WARN)], [cp("X Omitting glucose monitoring during HIET", WARN)], [cp("X Using calcium for BB toxicity alone (ineffective)", WARN)], [Spacer(1,3)], [cp("CORRECT: Calcium IS effective for CCB co-ingestion", GREEN_BOLD)], [cp("CORRECT: HIET works for both BB and CCB toxicity", GREEN_BOLD)]], bg=L_RED,border=RED)], ], colWidths=[col_w])) disp = zero(Table([ [sec_hdr("DISPOSITION", TEAL)], [wbox([[cp("<b>ICU/HDU admission for ALL symptomatic patients</b>", BOLD_BODY)], [b("Minimum 6 hours monitoring for asymptomatic patients")], [b("24 hours monitoring for modified-release formulations")], [b("Psychiatry consult for intentional self-harm overdose")], [b("Poison Control Centre consultation recommended")]], bg=L_GREEN,border=TEAL)], ], colWidths=[col_w])) ladder = zero(Table([ [sec_hdr("TREATMENT LADDER SUMMARY", DARK_NAVY)], [wbox([[cp("MILD (bradycardia + hypotension, responsive)", BOLD_BODY), cp("-> Atropine + Fluids", BODY)], [cp("MODERATE (persistent bradycardia/shock)", BOLD_BODY), cp("-> Glucagon + HIET", BODY)], [cp("SEVERE (refractory shock, AV block)", BOLD_BODY), cp("-> Pacing + Vasopressors + ILE", BODY)], [cp("REFRACTORY (cardiac arrest risk)", BOLD_BODY), cp("-> ECMO / IABP consider", BODY)]], bg=L_BLUE,border=DARK_NAVY,cw=[col_w*0.56, col_w*0.44])], ], colWidths=[col_w])) col3 = zero(Table([[inv],[Spacer(1,5)],[sotalol],[Spacer(1,5)],[pitfalls],[Spacer(1,5)],[disp],[Spacer(1,5)],[ladder]], colWidths=[col_w])) # ══ HEADER BANDS ══ h1 = Table([[cp("BETA BLOCKER TOXICITY: EMERGENCY MANAGEMENT GUIDE", MAIN_TITLE)]], colWidths=[W]) h1.setStyle(TableStyle([('BACKGROUND',(0,0),(-1,-1),DARK_NAVY), ('TOPPADDING',(0,0),(-1,-1),10),('BOTTOMPADDING',(0,0),(-1,-1),6), ('LEFTPADDING',(0,0),(-1,-1),8),('RIGHTPADDING',(0,0),(-1,-1),8)])) h2 = Table([[cp("Dr. Nayan Lakhmanbhai Varu | Guide: Dr. Bhavesh Jarwani | Co-Guide: Dr. Dharmishtra Dhusha", SUB_TITLE)]], colWidths=[W]) h2.setStyle(TableStyle([('BACKGROUND',(0,0),(-1,-1),MID_BLUE), ('TOPPADDING',(0,0),(-1,-1),5),('BOTTOMPADDING',(0,0),(-1,-1),5), ('LEFTPADDING',(0,0),(-1,-1),8),('RIGHTPADDING',(0,0),(-1,-1),8)])) h3 = Table([[cp("2nd Year Emergency Medicine Resident | Dept. of Emergency Medicine, Smt. NHL Medical College, Ahmedabad", INST_STY)]], colWidths=[W]) h3.setStyle(TableStyle([('BACKGROUND',(0,0),(-1,-1),colors.HexColor('#154360')), ('TOPPADDING',(0,0),(-1,-1),4),('BOTTOMPADDING',(0,0),(-1,-1),5), ('LEFTPADDING',(0,0),(-1,-1),8),('RIGHTPADDING',(0,0),(-1,-1),8)])) # ══ MAIN GRID ══ gap = 5*mm main = Table([[col1, Spacer(gap,1), col2, Spacer(gap,1), col3]], colWidths=[col_w,gap,col_w,gap,col_w]) main.setStyle(TableStyle([('TOPPADDING',(0,0),(-1,-1),0),('BOTTOMPADDING',(0,0),(-1,-1),0), ('LEFTPADDING',(0,0),(-1,-1),0),('RIGHTPADDING',(0,0),(-1,-1),0), ('VALIGN',(0,0),(-1,-1),'TOP')])) # ══ FOOTER ══ ftr = Table([[ cp("Keywords: Beta blocker toxicity • Bradycardia • Glucagon • HIET • Lipid emulsion • AV block • Emergency Department • Atenolol • Amlodipine • Cardiac poisoning", KEYWORD_S), cp("Dept. of Emergency Medicine | Smt. NHL Medical College, Ahmedabad | 2026", KEYWORD_S), ]], colWidths=[W*0.65, W*0.35]) ftr.setStyle(TableStyle([('BACKGROUND',(0,0),(-1,-1),DARK_NAVY), ('TOPPADDING',(0,0),(-1,-1),6),('BOTTOMPADDING',(0,0),(-1,-1),6), ('LEFTPADDING',(0,0),(-1,-1),10),('RIGHTPADDING',(0,0),(-1,-1),10)])) story = [h1, h2, h3, Spacer(1,5), main, Spacer(1,6), ftr] doc.build(story) print("SUCCESS:", output_path) PYEOF

python3 << 'PYEOF' import os os.makedirs("/tmp/workspace/nayan-abstract", exist_ok=True) from reportlab.lib.pagesizes import A3, landscape from reportlab.lib import colors from reportlab.lib.units import mm from reportlab.pdfgen import canvas from reportlab.platypus import Paragraph, Frame, KeepInFrame from reportlab.lib.styles import ParagraphStyle from reportlab.lib.enums import TA_CENTER, TA_LEFT PW, PH = landscape(A3) # 420 x 297 mm -> 1190.6 x 841.9 pts output_path = "/tmp/workspace/nayan-abstract/BetaBlocker_Toxicity_Management_Poster.pdf" # ── Colours ── DARK_NAVY = colors.HexColor('#0d1b2a') MID_BLUE = colors.HexColor('#1b4f72') RED = colors.HexColor('#c0392b') TEAL = colors.HexColor('#148f77') GOLD = colors.HexColor('#b7950b') PURPLE = colors.HexColor('#6c3483') BROWN = colors.HexColor('#784212') DBLUE2 = colors.HexColor('#1a5276') L_BLUE = colors.HexColor('#eaf4fb') L_RED = colors.HexColor('#fdedec') L_GREEN = colors.HexColor('#eafaf1') L_GOLD = colors.HexColor('#fef9e7') L_PURPLE = colors.HexColor('#f5eef8') L_BROWN = colors.HexColor('#fdf2e9') WHITE = colors.white GREY = colors.HexColor('#2c3e50') def mk(fn='Helvetica', fs=8, tc=GREY, al=TA_LEFT, ld=11): return ParagraphStyle('_', fontName=fn, fontSize=fs, textColor=tc, alignment=al, leading=ld, spaceAfter=1, spaceBefore=0) S_TITLE = mk('Helvetica-Bold', 16, WHITE, TA_CENTER, 20) S_SUB = mk('Helvetica', 9, colors.HexColor('#d6eaf8'), TA_CENTER, 12) S_INST = mk('Helvetica', 8, colors.HexColor('#aed6f1'), TA_CENTER, 11) S_SECH = mk('Helvetica-Bold', 9, WHITE, TA_CENTER, 12) S_SECH_L = mk('Helvetica-Bold', 9, WHITE, TA_LEFT, 12) S_BODY = mk('Helvetica', 7.5, GREY, TA_LEFT, 11) S_BOLD = mk('Helvetica-Bold', 7.5, GREY, TA_LEFT, 11) S_WARN = mk('Helvetica-Bold', 7.5, RED, TA_LEFT, 11) S_GREEN = mk('Helvetica-Bold', 7.5, TEAL, TA_LEFT, 11) S_SMALL = mk('Helvetica', 6.5, colors.HexColor('#666'),TA_LEFT,9) S_KW = mk('Helvetica', 7, WHITE, TA_CENTER, 10) S_STEP = mk('Helvetica-Bold', 11, WHITE, TA_CENTER, 14) def p(text, sty): return Paragraph(text, sty) def bl(text): return p(f"&#x2022; {text}", S_BODY) c = canvas.Canvas(output_path, pagesize=(PW, PH)) # ── helpers ── def rect_fill(cv, x, y, w, h, fill): cv.setFillColor(fill) cv.rect(x, y, w, h, stroke=0, fill=1) def draw_frame(cv, x, y, w, h, content, bg=None, border_col=None): if bg: cv.setFillColor(bg) cv.rect(x, y, w, h, stroke=0, fill=1) if border_col: cv.setStrokeColor(border_col) cv.setLineWidth(0.6) cv.rect(x, y, w, h, stroke=1, fill=0) f = Frame(x, y, w, h, leftPadding=4, rightPadding=4, topPadding=3, bottomPadding=3, showBoundary=0) kif = KeepInFrame(w, h, content, mode='shrink') f.addFromList([kif], cv) def sec_header(cv, x, y, w, h, text, bg, sty=S_SECH): rect_fill(cv, x, y, w, h, bg) f = Frame(x, y, w, h, leftPadding=4, rightPadding=4, topPadding=2, bottomPadding=2, showBoundary=0) kif = KeepInFrame(w, h, [p(text, sty)], mode='shrink') f.addFromList([kif], cv) def step_header(cv, x, y, w, h, num, title, bg): num_w = 18 rect_fill(cv, x, y, w, h, bg) # number circle area rect_fill(cv, x, y, num_w, h, bg) fn = Frame(x, y, num_w, h, leftPadding=1, rightPadding=1, topPadding=2, bottomPadding=2, showBoundary=0) fn.addFromList([KeepInFrame(num_w, h, [p(str(num), S_STEP)], mode='shrink')], cv) ft = Frame(x+num_w, y, w-num_w, h, leftPadding=4, rightPadding=4, topPadding=2, bottomPadding=2, showBoundary=0) ft.addFromList([KeepInFrame(w-num_w, h, [p(f"<b>{title}</b>", S_SECH_L)], mode='shrink')], cv) # ── Layout ── MAR = 10 HDR_H = 70 FTR_H = 22 COL_GAP = 6 CONTENT_Y = FTR_H + MAR CONTENT_H = PH - HDR_H - FTR_H - 2*MAR USABLE_W = PW - 2*MAR COL_W = (USABLE_W - 2*COL_GAP) / 3 cx1 = MAR cx2 = cx1 + COL_W + COL_GAP cx3 = cx2 + COL_W + COL_GAP # ═══ HEADER ═══ rect_fill(c, 0, PH-44, PW, 44, DARK_NAVY) rect_fill(c, 0, PH-62, PW, 18, MID_BLUE) rect_fill(c, 0, PH-76, PW, 14, colors.HexColor('#154360')) f = Frame(MAR, PH-44, PW-2*MAR, 40, leftPadding=4, rightPadding=4, topPadding=4, bottomPadding=2, showBoundary=0) f.addFromList([KeepInFrame(PW-2*MAR, 40, [p("BETA BLOCKER TOXICITY: EMERGENCY MANAGEMENT GUIDE", S_TITLE)], mode='shrink')], c) f2 = Frame(MAR, PH-62, PW-2*MAR, 18, leftPadding=4, rightPadding=4, topPadding=2, bottomPadding=2, showBoundary=0) f2.addFromList([KeepInFrame(PW-2*MAR, 18, [p("Dr. Nayan Lakhmanbhai Varu | Guide: Dr. Bhavesh Jarwani | Co-Guide: Dr. Dharmishtra Dhusha", S_SUB)], mode='shrink')], c) f3 = Frame(MAR, PH-76, PW-2*MAR, 14, leftPadding=4, rightPadding=4, topPadding=1, bottomPadding=1, showBoundary=0) f3.addFromList([KeepInFrame(PW-2*MAR, 14, [p("2nd Year Emergency Medicine Resident | Dept. of Emergency Medicine, Smt. NHL Medical College, Ahmedabad", S_INST)], mode='shrink')], c) # ═══ FOOTER ═══ rect_fill(c, 0, 0, PW, FTR_H, DARK_NAVY) ff = Frame(MAR, 0, PW-2*MAR, FTR_H, leftPadding=6, rightPadding=6, topPadding=4, bottomPadding=4, showBoundary=0) ff.addFromList([KeepInFrame(PW-2*MAR, FTR_H, [ p("Keywords: Beta blocker toxicity • Bradycardia • Glucagon • HIET • Lipid emulsion • AV block • Emergency Dept. • Atenolol • Amlodipine • Cardiac poisoning", S_KW), p("Dept. of Emergency Medicine | Smt. NHL Medical College, Ahmedabad | 2026", S_KW), ], mode='shrink')], c) # ═══ COLUMN DRAWING HELPER ═══ SH = 14 # section header height ITH = 12 # item row height def draw_section(cv, x, top_y, w, title, bg_hdr, items, bg_body, bdr, item_style=None): if item_style is None: item_style = S_BODY body_h = len(items) * ITH + 6 total_h = SH + body_h # header sec_header(cv, x, top_y - SH, w, SH, title, bg_hdr) # body rect_fill(cv, x, top_y - SH - body_h, w, body_h, bg_body) cv.setStrokeColor(bdr); cv.setLineWidth(0.6) cv.rect(x, top_y - SH - body_h, w, body_h, stroke=1, fill=0) content = [p(f"&#x2022; {it}", item_style) for it in items] fb = Frame(x, top_y - SH - body_h, w, body_h, leftPadding=5, rightPadding=4, topPadding=3, bottomPadding=3, showBoundary=0) fb.addFromList([KeepInFrame(w, body_h, content, mode='shrink')], cv) return top_y - total_h def draw_section_2col(cv, x, top_y, w, title, bg_hdr, col1_items, col2_items, bg_body, bdr): body_h = max(len(col1_items), len(col2_items)) * ITH + 6 total_h = SH + body_h sec_header(cv, x, top_y - SH, w, title, bg_hdr) rect_fill(cv, x, top_y - SH - body_h, w, body_h, bg_body) cv.setStrokeColor(bdr); cv.setLineWidth(0.6) cv.rect(x, top_y - SH - body_h, w, body_h, stroke=1, fill=0) hw = w / 2 c1 = [p(f"&#x2022; {it}", S_BODY) for it in col1_items] c2 = [p(f"&#x2022; {it}", S_BODY) for it in col2_items] Frame(x, top_y-SH-body_h, hw, body_h, leftPadding=5, rightPadding=3, topPadding=3, bottomPadding=3, showBoundary=0).addFromList([KeepInFrame(hw, body_h, c1, mode='shrink')], cv) Frame(x+hw, top_y-SH-body_h, hw, body_h, leftPadding=5, rightPadding=3, topPadding=3, bottomPadding=3, showBoundary=0).addFromList([KeepInFrame(hw, body_h, c2, mode='shrink')], cv) return top_y - total_h def draw_step(cv, x, top_y, w, num, title, items, cn, cb, cd): num_w = 18 bh = len(items) * ITH + 6 total_h = SH + bh step_header(cv, x, top_y - SH, w, SH, num, title, cn) rect_fill(cv, x, top_y - SH - bh, w, bh, cb) cv.setStrokeColor(cd); cv.setLineWidth(0.6) cv.rect(x, top_y - SH - bh, w, bh, stroke=1, fill=0) content = [p(f"&#x2022; {it}", S_BODY) for it in items] Frame(x, top_y-SH-bh, w, bh, leftPadding=5, rightPadding=4, topPadding=3, bottomPadding=3, showBoundary=0).addFromList([KeepInFrame(w, bh, content, mode='shrink')], cv) return top_y - total_h GAP = 5 top = CONTENT_Y + CONTENT_H # ══════════════════════ COLUMN 1 ══════════════════════ y = top # Pharmacology sec_header(c, cx1, y-SH, COL_W, SH, "PHARMACOLOGY & MECHANISM", DARK_NAVY) pharm_body_h = 13*ITH + 6 rect_fill(c, cx1, y-SH-pharm_body_h, COL_W, pharm_body_h, L_BLUE) c.setStrokeColor(MID_BLUE); c.setLineWidth(0.6) c.rect(cx1, y-SH-pharm_body_h, COL_W, pharm_body_h, stroke=1, fill=0) pharm_content = [ p("<b>Beta-1 (cardiac):</b> SA node, AV node, myocardium", S_BODY), p("<b>Beta-2 (peripheral):</b> Bronchi, vasculature, liver", S_BODY), p(" ", S_SMALL), p("<b>Mechanism of Toxicity:</b>", S_BOLD), bl("Competitive blockade of beta-adrenergic receptors"), bl("Decreased cAMP -> decreased Ca2+ entry -> myocardial depression"), bl("Bradycardia, reduced inotropy and chronotropy"), bl("Propranolol: Na+ channel blockade -> QRS widening"), bl("Non-selective agents -> hypoglycaemia"), p(" ", S_SMALL), p("<b>Lipophilic (cross BBB):</b> Propranolol, metoprolol, labetalol", S_BODY), p("<b>Hydrophilic:</b> Atenolol, sotalol", S_BODY), ] Frame(cx1, y-SH-pharm_body_h, COL_W, pharm_body_h, leftPadding=5, rightPadding=4, topPadding=3, bottomPadding=3, showBoundary=0).addFromList([KeepInFrame(COL_W, pharm_body_h, pharm_content, mode='shrink')], c) y -= (SH + pharm_body_h + GAP) # Clinical Features 2-col y = draw_section_2col(c, cx1, y, COL_W, "CLINICAL FEATURES", RED, ["Bradycardia","Hypotension","AV block (I-III)","Wide QRS","Cardiogenic shock","Asystole"], ["Altered sensorium","Seizures (propranolol)","Coma","Bronchospasm","Hypoglycaemia","Hypothermia"], L_RED, RED) y -= GAP # ECG Findings y = draw_section(c, cx1, y, COL_W, "ECG FINDINGS", PURPLE, ["Sinus bradycardia (most common)", "1st degree AV block - prolonged PR interval", "Mobitz II / Complete (3rd degree) AV block", "Wide QRS complex (Na+ channel blockade)", "Junctional or idioventricular rhythm", "VT/VF - sotalol causes QT prolongation", "Asystole in severe overdose", "Continuous cardiac monitoring is MANDATORY"], L_PURPLE, PURPLE) # ══════════════════════ COLUMN 2 ══════════════════════ y2 = top mh_h = SH rect_fill(c, cx2, y2-mh_h, COL_W, mh_h, DARK_NAVY) Frame(cx2, y2-mh_h, COL_W, mh_h, leftPadding=4, rightPadding=4, topPadding=2, bottomPadding=2, showBoundary=0).addFromList([KeepInFrame(COL_W, mh_h, [p("STEPWISE MANAGEMENT ALGORITHM", S_SECH)], mode='shrink')], c) y2 -= (mh_h + GAP) y2 = draw_step(c, cx2, y2, COL_W, 1, "IMMEDIATE RESUSCITATION (0-5 min)", ["ABC - Airway, Breathing, Circulation","High-flow O2 / Bag-mask if needed","IV access x2, Cardiac monitor, SpO2","12-lead ECG stat - QRS, PR, QT intervals","POC glucose - rule out hypoglycaemia","NS fluid bolus 10-20 mL/kg if hypotensive"],RED,L_RED,RED) y2 -= GAP y2 = draw_step(c, cx2, y2, COL_W, 2, "DECONTAMINATION (if within 1-2 hrs)", ["Activated charcoal 1 g/kg PO/NG (if GCS intact)","Gastric lavage: large ingestion within 1 hr","Do NOT induce emesis","Whole bowel irrigation for slow-release tabs"],GOLD,L_GOLD,GOLD) y2 -= GAP y2 = draw_step(c, cx2, y2, COL_W, 3, "ATROPINE", ["0.5-1 mg IV bolus, repeat up to 3 mg total","Usually insufficient alone in severe toxicity","Use as bridge while preparing escalation therapy"],DBLUE2,L_BLUE,MID_BLUE) y2 -= GAP y2 = draw_step(c, cx2, y2, COL_W, 4, "GLUCAGON - First-line Antidote", ["Bolus: 3-10 mg IV over 3-5 minutes","Infusion: 1-5 mg/hr if response achieved","Acts via non-adrenergic pathway - increases cAMP","Side effects: vomiting, hyperglycaemia","Short duration - escalate to HIET if still unstable"],TEAL,L_GREEN,TEAL) y2 -= GAP y2 = draw_step(c, cx2, y2, COL_W, 5, "HIGH-DOSE INSULIN EUGLYCAEMIA THERAPY (HIET)", ["Insulin: 1 unit/kg IV bolus -> 0.5-1 unit/kg/hr","Dextrose 50%: 50 mL bolus if glucose < 250 mg/dL","D10W infusion: 0.5 g/kg/hr to maintain euglycaemia","Blood glucose check every 15-30 minutes","Monitor potassium (risk of hypokalaemia)","Preferred in cardiogenic shock - improves inotropy"],PURPLE,L_PURPLE,PURPLE) y2 -= GAP y2 = draw_step(c, cx2, y2, COL_W, 6, "IV LIPID EMULSION - Rescue Therapy", ["20% Intralipid: 1.5 mL/kg IV bolus over 1 min","Repeat bolus x2 if no response (max 3 boluses)","Infusion: 0.25-0.5 mL/kg/min for 30-60 min","Max dose: 10-12 mL/kg total","Mechanism: lipid sink sequesters lipophilic drug","Most effective for propranolol toxicity"],BROWN,L_BROWN,BROWN) y2 -= GAP y2 = draw_step(c, cx2, y2, COL_W, 7, "PACING / ADVANCED SUPPORT", ["Transcutaneous pacing if atropine fails","Transvenous pacemaker for complete AV block","Vasopressors: Noradrenaline/Adrenaline for shock","ECMO / IABP in refractory cardiogenic shock","Haemodialysis: atenolol, sotalol (hydrophilic)"],RED,L_RED,RED) # ══════════════════════ COLUMN 3 ══════════════════════ y3 = top # Investigations 3-col sec_header(c, cx3, y3-SH, COL_W, SH, "INVESTIGATIONS", DBLUE2) inv_bh = 8*ITH + 6 rect_fill(c, cx3, y3-SH-inv_bh, COL_W, inv_bh, L_BLUE) c.setStrokeColor(DBLUE2); c.setLineWidth(0.6) c.rect(cx3, y3-SH-inv_bh, COL_W, inv_bh, stroke=1, fill=0) iw = COL_W/3 for ci, (hdr, items) in enumerate([ ("Bedside", ["ECG (stat)","POC Glucose","SpO2","NIBP / IBP"]), ("Laboratory", ["ABG + Lactate","CBC, RFT, LFT","Electrolytes","Troponin I","Drug level*"]), ("Imaging", ["CXR","Echo if shock","","",""]) ]): ix = cx3 + ci*iw Frame(ix, y3-SH-inv_bh, iw, inv_bh,leftPadding=4,rightPadding=2,topPadding=3,bottomPadding=2,showBoundary=0).addFromList([KeepInFrame(iw,inv_bh,[p(f"<b>{hdr}</b>",S_BOLD)]+[bl(i) for i in items]+([p("*clinical diagnosis",S_SMALL)] if ci==1 else []),mode='shrink')],c) y3 -= (SH + inv_bh + GAP) # Sotalol y3 = draw_section(c, cx3, y3, COL_W, "SOTALOL - SPECIAL CONSIDERATION", PURPLE, ["Causes QT prolongation -> Torsades de Pointes (TdP)", "Glucagon less effective (K+ channel mechanism)", "IV Magnesium sulphate 2 g over 10 min for TdP", "Overdrive pacing if TdP is recurrent", "Haemodialysis effective (hydrophilic agent)", "Isoproterenol infusion may be considered"],L_PURPLE,PURPLE) y3 -= GAP # Common Pitfalls sec_header(c, cx3, y3-SH, COL_W, SH, "COMMON PITFALLS", RED) pit_bh = 10*ITH + 6 rect_fill(c, cx3, y3-SH-pit_bh, COL_W, pit_bh, L_RED) c.setStrokeColor(RED); c.setLineWidth(0.6) c.rect(cx3, y3-SH-pit_bh, COL_W, pit_bh, stroke=1, fill=0) pit_content = [ p("&#x2718; Relying on atropine alone in severe toxicity", S_WARN), p("&#x2718; Delaying HIET - use early, not as last resort", S_WARN), p("&#x2718; Missing co-ingestion: CCB + BB is catastrophic", S_WARN), p("&#x2718; Early discharge with slow-release formulations", S_WARN), p("&#x2718; Omitting glucose monitoring during HIET", S_WARN), p("&#x2718; Calcium alone for BB toxicity (ineffective)", S_WARN), p(" ", S_SMALL), p("&#x2714; Calcium IS effective for CCB co-ingestion", S_GREEN), p("&#x2714; HIET works for both BB and CCB toxicity", S_GREEN), ] Frame(cx3, y3-SH-pit_bh, COL_W, pit_bh,leftPadding=5,rightPadding=4,topPadding=3,bottomPadding=3,showBoundary=0).addFromList([KeepInFrame(COL_W,pit_bh,pit_content,mode='shrink')],c) y3 -= (SH + pit_bh + GAP) # Disposition y3 = draw_section(c, cx3, y3, COL_W, "DISPOSITION", TEAL, ["ICU/HDU admission for ALL symptomatic patients", "Minimum 6 hours monitoring for asymptomatic cases", "24 hours monitoring for modified-release formulations", "Psychiatry consult for intentional overdose", "Poison Control Centre consultation recommended"],L_GREEN,TEAL) y3 -= GAP # Treatment Ladder sec_header(c, cx3, y3-SH, COL_W, SH, "TREATMENT LADDER SUMMARY", DARK_NAVY) lad_bh = 5*ITH + 4 rect_fill(c, cx3, y3-SH-lad_bh, COL_W, lad_bh, L_BLUE) c.setStrokeColor(DARK_NAVY); c.setLineWidth(0.6) c.rect(cx3, y3-SH-lad_bh, COL_W, lad_bh, stroke=1, fill=0) lw1 = COL_W*0.55; lw2 = COL_W*0.45 lad_rows = [ ("MILD (bradycardia + hypotension, responsive)", "-> Atropine + Fluids"), ("MODERATE (persistent bradycardia/shock)", "-> Glucagon + HIET"), ("SEVERE (refractory shock, AV block)", "-> Pacing + Vasopressors + ILE"), ("REFRACTORY (cardiac arrest risk)", "-> ECMO / IABP consider"), ] Frame(cx3, y3-SH-lad_bh, lw1, lad_bh,leftPadding=5,rightPadding=3,topPadding=3,bottomPadding=3,showBoundary=0).addFromList([KeepInFrame(lw1,lad_bh,[p(r[0],S_BOLD) for r in lad_rows],mode='shrink')],c) Frame(cx3+lw1, y3-SH-lad_bh, lw2, lad_bh,leftPadding=4,rightPadding=3,topPadding=3,bottomPadding=3,showBoundary=0).addFromList([KeepInFrame(lw2,lad_bh,[p(r[1],S_BODY) for r in lad_rows],mode='shrink')],c) c.save() print("SUCCESS:", output_path) PYEOF

python3 /tmp/workspace/nayan-abstract/make_poster.py 2>&1 || true # First write the script cleanly cat > /tmp/workspace/nayan-abstract/make_poster.py << 'PYEOF' import os from reportlab.lib.pagesizes import A3, landscape from reportlab.lib import colors from reportlab.lib.units import mm from reportlab.pdfgen import canvas from reportlab.platypus import Paragraph, Frame, KeepInFrame from reportlab.lib.styles import ParagraphStyle from reportlab.lib.enums import TA_CENTER, TA_LEFT PW, PH = landscape(A3) output_path = "/tmp/workspace/nayan-abstract/BetaBlocker_Toxicity_Management_Poster.pdf" DARK_NAVY = colors.HexColor('#0d1b2a') MID_BLUE = colors.HexColor('#1b4f72') RED = colors.HexColor('#c0392b') TEAL = colors.HexColor('#148f77') GOLD = colors.HexColor('#b7950b') PURPLE = colors.HexColor('#6c3483') BROWN = colors.HexColor('#784212') DBLUE2 = colors.HexColor('#1a5276') L_BLUE = colors.HexColor('#eaf4fb') L_RED = colors.HexColor('#fdedec') L_GREEN = colors.HexColor('#eafaf1') L_GOLD = colors.HexColor('#fef9e7') L_PURPLE = colors.HexColor('#f5eef8') L_BROWN = colors.HexColor('#fdf2e9') WHITE = colors.white GREY = colors.HexColor('#2c3e50') def mk(fn='Helvetica', fs=8, tc=GREY, al=TA_LEFT, ld=11): return ParagraphStyle('_', fontName=fn, fontSize=fs, textColor=tc, alignment=al, leading=ld, spaceAfter=1, spaceBefore=0) S_TITLE = mk('Helvetica-Bold', 16, WHITE, TA_CENTER, 20) S_SUB = mk('Helvetica', 9, colors.HexColor('#d6eaf8'), TA_CENTER, 12) S_INST = mk('Helvetica', 8, colors.HexColor('#aed6f1'), TA_CENTER, 11) S_SECH = mk('Helvetica-Bold', 9, WHITE, TA_CENTER, 12) S_SECHL = mk('Helvetica-Bold', 9, WHITE, TA_LEFT, 12) S_BODY = mk('Helvetica', 7.5, GREY, TA_LEFT, 11) S_BOLD = mk('Helvetica-Bold',7.5, GREY, TA_LEFT, 11) S_WARN = mk('Helvetica-Bold',7.5, RED, TA_LEFT, 11) S_GREEN = mk('Helvetica-Bold',7.5, TEAL, TA_LEFT, 11) S_SMALL = mk('Helvetica', 6.5, colors.HexColor('#666'), TA_LEFT, 9) S_KW = mk('Helvetica', 7, WHITE, TA_CENTER, 10) S_STEP = mk('Helvetica-Bold', 11, WHITE, TA_CENTER, 14) def p(text, sty): return Paragraph(text, sty) def bl(text): return p(f"&#x2022; {text}", S_BODY) cv = canvas.Canvas(output_path, pagesize=(PW, PH)) def rfill(x, y, w, h, fill): cv.setFillColor(fill) cv.rect(x, y, w, h, stroke=0, fill=1) def draw_frm(x, y, w, h, content, bg=None, bdr=None): if bg: rfill(x, y, w, h, bg) if bdr: cv.setStrokeColor(bdr); cv.setLineWidth(0.6) cv.rect(x, y, w, h, stroke=1, fill=0) f = Frame(x, y, w, h, leftPadding=5, rightPadding=4, topPadding=3, bottomPadding=3, showBoundary=0) f.addFromList([KeepInFrame(w, h, content, mode='shrink')], cv) def sec_hdr(x, y, w, h, text, bg): rfill(x, y, w, h, bg) f = Frame(x, y, w, h, leftPadding=5, rightPadding=4, topPadding=2, bottomPadding=2, showBoundary=0) f.addFromList([KeepInFrame(w, h, [p(text, S_SECH)], mode='shrink')], cv) def step_hdr(x, y, w, h, num, title, bg): rfill(x, y, w, h, bg) nw = 18 Frame(x, y, nw, h, leftPadding=1, rightPadding=1, topPadding=1, bottomPadding=1, showBoundary=0).addFromList([KeepInFrame(nw, h, [p(str(num), S_STEP)], mode='shrink')], cv) Frame(x+nw, y, w-nw, h, leftPadding=5, rightPadding=4, topPadding=2, bottomPadding=2, showBoundary=0).addFromList([KeepInFrame(w-nw, h, [p(f"<b>{title}</b>", S_SECHL)], mode='shrink')], cv) MAR = 10; SH = 14; ITH = 12; GAP = 4 FTR_H = 22 HDR_H = 76 CONTENT_Y = FTR_H + MAR CONTENT_H = PH - HDR_H - FTR_H - 2*MAR UW = PW - 2*MAR CW = (UW - 12) / 3 cx1 = MAR; cx2 = cx1+CW+6; cx3 = cx2+CW+6 def dsec(x, y, w, title, bg_h, items, bg_b, bdr, sty=None): if sty is None: sty = S_BODY bh = len(items)*ITH + 6 sec_hdr(x, y-SH, w, SH, title, bg_h) draw_frm(x, y-SH-bh, w, bh, [p(f"&#x2022; {i}", sty) for i in items], bg=bg_b, bdr=bdr) return y - SH - bh def dstep(x, y, w, num, title, items, cn, cb, cd): bh = len(items)*ITH + 6 step_hdr(x, y-SH, w, SH, num, title, cn) draw_frm(x, y-SH-bh, w, bh, [bl(i) for i in items], bg=cb, bdr=cd) return y - SH - bh top = CONTENT_Y + CONTENT_H # ══ HEADER ══ rfill(0, PH-44, PW, 44, DARK_NAVY) rfill(0, PH-62, PW, 18, MID_BLUE) rfill(0, PH-76, PW, 14, colors.HexColor('#154360')) Frame(MAR,PH-44,PW-2*MAR,40,leftPadding=4,rightPadding=4,topPadding=4,bottomPadding=2,showBoundary=0).addFromList([KeepInFrame(PW-2*MAR,40,[p("BETA BLOCKER TOXICITY: EMERGENCY MANAGEMENT GUIDE",S_TITLE)],mode='shrink')],cv) Frame(MAR,PH-62,PW-2*MAR,18,leftPadding=4,rightPadding=4,topPadding=2,bottomPadding=2,showBoundary=0).addFromList([KeepInFrame(PW-2*MAR,18,[p("Dr. Nayan Lakhmanbhai Varu | Guide: Dr. Bhavesh Jarwani | Co-Guide: Dr. Dharmishtra Dhusha",S_SUB)],mode='shrink')],cv) Frame(MAR,PH-76,PW-2*MAR,14,leftPadding=4,rightPadding=4,topPadding=1,bottomPadding=1,showBoundary=0).addFromList([KeepInFrame(PW-2*MAR,14,[p("2nd Year Emergency Medicine Resident | Dept. of Emergency Medicine, Smt. NHL Medical College, Ahmedabad",S_INST)],mode='shrink')],cv) # ══ FOOTER ══ rfill(0, 0, PW, FTR_H, DARK_NAVY) Frame(MAR,0,PW-2*MAR,FTR_H,leftPadding=6,rightPadding=6,topPadding=4,bottomPadding=4,showBoundary=0).addFromList([KeepInFrame(PW-2*MAR,FTR_H,[p("Keywords: Beta blocker toxicity • Bradycardia • Glucagon • HIET • Lipid emulsion • AV block • Emergency Dept. • Atenolol • Amlodipine • Cardiac poisoning",S_KW),p("Dept. of Emergency Medicine | Smt. NHL Medical College, Ahmedabad | 2026",S_KW)],mode='shrink')],cv) # ══ COL 1 ══ y1 = top sec_hdr(cx1, y1-SH, CW, SH, "PHARMACOLOGY & MECHANISM", DARK_NAVY) pbh = 13*ITH+6 draw_frm(cx1, y1-SH-pbh, CW, pbh, [ p("<b>Beta-1 (cardiac):</b> SA node, AV node, myocardium", S_BODY), p("<b>Beta-2 (peripheral):</b> Bronchi, vasculature, liver", S_BODY), p(" ", S_SMALL), p("<b>Mechanism of Toxicity:</b>", S_BOLD), bl("Competitive blockade of beta-adrenergic receptors"), bl("Decreased cAMP -> decreased Ca2+ entry -> myocardial depression"), bl("Bradycardia, reduced inotropy and chronotropy"), bl("Propranolol: Na+ channel blockade -> QRS widening"), bl("Non-selective agents -> hypoglycaemia"), p(" ", S_SMALL), p("<b>Lipophilic (cross BBB):</b> Propranolol, metoprolol, labetalol", S_BODY), p("<b>Hydrophilic:</b> Atenolol, sotalol", S_BODY), ], bg=L_BLUE, bdr=MID_BLUE) y1 -= (SH+pbh+GAP) # Clinical Features 2-col sec_hdr(cx1, y1-SH, CW, SH, "CLINICAL FEATURES", RED) cbh = 7*ITH+6 rfill(cx1, y1-SH-cbh, CW, cbh, L_RED) cv.setStrokeColor(RED); cv.setLineWidth(0.6); cv.rect(cx1, y1-SH-cbh, CW, cbh, stroke=1, fill=0) hw = CW/2 Frame(cx1, y1-SH-cbh, hw, cbh,leftPadding=5,rightPadding=3,topPadding=3,bottomPadding=3,showBoundary=0).addFromList([KeepInFrame(hw,cbh,[p("<b>Cardiovascular</b>",S_BOLD)]+[bl(i) for i in ["Bradycardia","Hypotension","AV block (I-III)","Wide QRS","Cardiogenic shock","Asystole"]],mode='shrink')],cv) Frame(cx1+hw, y1-SH-cbh, hw, cbh,leftPadding=5,rightPadding=3,topPadding=3,bottomPadding=3,showBoundary=0).addFromList([KeepInFrame(hw,cbh,[p("<b>CNS / Other</b>",S_BOLD)]+[bl(i) for i in ["Altered sensorium","Seizures (propranolol)","Coma","Bronchospasm","Hypoglycaemia","Hypothermia"]],mode='shrink')],cv) y1 -= (SH+cbh+GAP) y1 = dsec(cx1, y1, CW, "ECG FINDINGS", PURPLE, ["Sinus bradycardia (most common)","1st degree AV block - prolonged PR interval", "Mobitz II / Complete (3rd degree) AV block","Wide QRS complex (Na+ channel blockade)", "Junctional or idioventricular rhythm","VT/VF - sotalol causes QT prolongation", "Asystole in severe overdose","Continuous cardiac monitoring is MANDATORY"], L_PURPLE, PURPLE) # ══ COL 2 ══ y2 = top sec_hdr(cx2, y2-SH, CW, SH, "STEPWISE MANAGEMENT ALGORITHM", DARK_NAVY) y2 -= (SH+GAP) y2 = dstep(cx2,y2,CW,1,"IMMEDIATE RESUSCITATION (0-5 min)",["ABC - Airway, Breathing, Circulation","High-flow O2 / Bag-mask ventilation if needed","IV access x2, Cardiac monitor, SpO2","12-lead ECG stat - QRS, PR, QT intervals","POC glucose - rule out hypoglycaemia","NS fluid bolus 10-20 mL/kg if hypotensive"],RED,L_RED,RED); y2-=GAP y2 = dstep(cx2,y2,CW,2,"DECONTAMINATION (within 1-2 hrs)",["Activated charcoal 1 g/kg PO/NG (if GCS intact)","Gastric lavage: large ingestion within 1 hr only","Do NOT induce emesis","Whole bowel irrigation for slow-release formulations"],GOLD,L_GOLD,GOLD); y2-=GAP y2 = dstep(cx2,y2,CW,3,"ATROPINE",["0.5-1 mg IV bolus, repeat up to 3 mg total","Usually insufficient alone in severe toxicity","Use as bridge while preparing escalation therapy"],DBLUE2,L_BLUE,MID_BLUE); y2-=GAP y2 = dstep(cx2,y2,CW,4,"GLUCAGON - First-line Antidote",["Bolus: 3-10 mg IV over 3-5 minutes","Infusion: 1-5 mg/hr if response achieved","Acts via non-adrenergic pathway - increases cAMP","Side effects: vomiting, hyperglycaemia","Short duration - escalate to HIET if still unstable"],TEAL,L_GREEN,TEAL); y2-=GAP y2 = dstep(cx2,y2,CW,5,"HIGH-DOSE INSULIN EUGLYCAEMIA THERAPY (HIET)",["Insulin: 1 unit/kg IV bolus -> 0.5-1 unit/kg/hr","Dextrose 50%: 50 mL bolus if glucose < 250 mg/dL","D10W: 0.5 g/kg/hr to maintain euglycaemia","Blood glucose check every 15-30 minutes","Monitor potassium (risk of hypokalaemia)","Preferred in cardiogenic shock - improves inotropy"],PURPLE,L_PURPLE,PURPLE); y2-=GAP y2 = dstep(cx2,y2,CW,6,"IV LIPID EMULSION - Rescue Therapy",["20% Intralipid: 1.5 mL/kg IV bolus over 1 min","Repeat bolus x2 if no response (max 3 boluses)","Infusion: 0.25-0.5 mL/kg/min for 30-60 min","Max dose: 10-12 mL/kg total","Mechanism: lipid sink sequesters lipophilic drug","Most effective for propranolol toxicity"],BROWN,L_BROWN,BROWN); y2-=GAP y2 = dstep(cx2,y2,CW,7,"PACING / ADVANCED SUPPORT",["Transcutaneous pacing if atropine fails","Transvenous pacemaker for complete AV block","Vasopressors: Noradrenaline/Adrenaline for shock","ECMO / IABP in refractory cardiogenic shock","Haemodialysis: atenolol, sotalol (hydrophilic)"],RED,L_RED,RED) # ══ COL 3 ══ y3 = top sec_hdr(cx3, y3-SH, CW, SH, "INVESTIGATIONS", DBLUE2) ibh = 7*ITH+6 rfill(cx3, y3-SH-ibh, CW, ibh, L_BLUE) cv.setStrokeColor(DBLUE2); cv.setLineWidth(0.6); cv.rect(cx3, y3-SH-ibh, CW, ibh, stroke=1, fill=0) iw3 = CW/3 for ci,(hdr,items) in enumerate([ ("Bedside", ["ECG (stat)","POC Glucose","SpO2","NIBP / IBP","",""]), ("Laboratory", ["ABG + Lactate","CBC, RFT, LFT","Electrolytes","Troponin I","Drug level*",""]), ("Imaging", ["CXR","Echo if shock","","","",""]) ]): ix = cx3 + ci*iw3 content = [p(f"<b>{hdr}</b>",S_BOLD)]+[bl(i) for i in items if i] if ci==1: content.append(p("*clinical dx",S_SMALL)) Frame(ix,y3-SH-ibh,iw3,ibh,leftPadding=4,rightPadding=2,topPadding=3,bottomPadding=2,showBoundary=0).addFromList([KeepInFrame(iw3,ibh,content,mode='shrink')],cv) y3 -= (SH+ibh+GAP) y3 = dsec(cx3,y3,CW,"SOTALOL - SPECIAL CONSIDERATION",PURPLE, ["Causes QT prolongation -> Torsades de Pointes (TdP)","Glucagon less effective (K+ channel mechanism)", "IV Magnesium sulphate 2 g over 10 min for TdP","Overdrive pacing if TdP is recurrent", "Haemodialysis effective (hydrophilic agent)","Isoproterenol infusion may be considered"],L_PURPLE,PURPLE); y3-=GAP # Pitfalls sec_hdr(cx3, y3-SH, CW, SH, "COMMON PITFALLS", RED) pbh2 = 10*ITH+6 rfill(cx3, y3-SH-pbh2, CW, pbh2, L_RED) cv.setStrokeColor(RED); cv.setLineWidth(0.6); cv.rect(cx3, y3-SH-pbh2, CW, pbh2, stroke=1, fill=0) Frame(cx3,y3-SH-pbh2,CW,pbh2,leftPadding=5,rightPadding=4,topPadding=3,bottomPadding=3,showBoundary=0).addFromList([KeepInFrame(CW,pbh2,[ p("&#x2718; Relying on atropine alone in severe toxicity",S_WARN), p("&#x2718; Delaying HIET - use early, not as last resort",S_WARN), p("&#x2718; Missing co-ingestion: CCB + BB is catastrophic",S_WARN), p("&#x2718; Early discharge with slow-release formulations",S_WARN), p("&#x2718; Omitting glucose monitoring during HIET",S_WARN), p("&#x2718; Calcium alone for BB toxicity (ineffective)",S_WARN), p(" ",S_SMALL), p("&#x2714; Calcium IS effective for CCB co-ingestion",S_GREEN), p("&#x2714; HIET works for both BB and CCB toxicity",S_GREEN), ],mode='shrink')],cv) y3 -= (SH+pbh2+GAP) y3 = dsec(cx3,y3,CW,"DISPOSITION",TEAL, ["ICU/HDU for ALL symptomatic patients","Min 6 hrs monitoring for asymptomatic cases", "24 hrs monitoring for modified-release tabs","Psychiatry consult for intentional overdose", "Poison Control Centre consultation recommended"],L_GREEN,TEAL); y3-=GAP # Ladder sec_hdr(cx3, y3-SH, CW, SH, "TREATMENT LADDER SUMMARY", DARK_NAVY) lbh = 5*ITH+4 rfill(cx3, y3-SH-lbh, CW, lbh, L_BLUE) cv.setStrokeColor(DARK_NAVY); cv.setLineWidth(0.6); cv.rect(cx3, y3-SH-lbh, CW, lbh, stroke=1, fill=0) lw1=CW*0.56; lw2=CW*0.44 rows=[("MILD (responsive to initial Rx)","-> Atropine + Fluids"), ("MODERATE (persistent brady/shock)","-> Glucagon + HIET"), ("SEVERE (refractory shock, AV block)","-> Pacing + Vasopressors + ILE"), ("REFRACTORY (cardiac arrest risk)","-> ECMO / IABP consider")] Frame(cx3,y3-SH-lbh,lw1,lbh,leftPadding=5,rightPadding=3,topPadding=3,bottomPadding=3,showBoundary=0).addFromList([KeepInFrame(lw1,lbh,[p(r[0],S_BOLD) for r in rows],mode='shrink')],cv) Frame(cx3+lw1,y3-SH-lbh,lw2,lbh,leftPadding=4,rightPadding=3,topPadding=3,bottomPadding=3,showBoundary=0).addFromList([KeepInFrame(lw2,lbh,[p(r[1],S_BODY) for r in rows],mode='shrink')],cv) cv.save() print("SUCCESS:", output_path) PYEOF python3 /tmp/workspace/nayan-abstract/make_poster.py

python3 -c " import pdfplumber with pdfplumber.open('/tmp/workspace/attachments/7a8835e7-ff0d-4b19-84ee-df5a8e258518/PRAMIT (1).pdf') as pdf: print(f'Pages: {len(pdf.pages)}') for i, page in enumerate(pdf.pages): print(f'--- PAGE {i+1} ---') print(f'Width: {page.width}, Height: {page.height}') text = page.extract_text() print(text) "

python3 -c " import pdfplumber with pdfplumber.open('/tmp/workspace/attachments/7a8835e7-ff0d-4b19-84ee-df5a8e258518/PRAMIT (1).pdf') as pdf: page = pdf.pages[0] # Get all text with position info words = page.extract_words() for w in words[:60]: print(f\"x0={w['x0']:.1f} top={w['top']:.1f} x1={w['x1']:.1f} bottom={w['bottom']:.1f} text='{w['text']}'\") "

python3 -c " import pdfplumber with pdfplumber.open('/tmp/workspace/attachments/7a8835e7-ff0d-4b19-84ee-df5a8e258518/PRAMIT (1).pdf') as pdf: page = pdf.pages[0] # Get chars with font info chars = page.chars # sample unique fonts/sizes seen = set() for ch in chars: key = (ch.get('fontname',''), ch.get('size',0)) if key not in seen: seen.add(key) print(f\"font={ch.get('fontname','')} size={ch.get('size',0):.1f} text='{ch.get('text','')}' top={ch.get('top',0):.1f}\") print() print('--- checking colors/lines ---') rects = page.rects print(f'Rects: {len(rects)}') for r in rects[:10]: print(r) lines = page.lines print(f'Lines: {len(lines)}') for l in lines[:10]: print(l) "

python3 -c " import pdfplumber with pdfplumber.open('/tmp/workspace/attachments/7a8835e7-ff0d-4b19-84ee-df5a8e258518/PRAMIT (1).pdf') as pdf: page = pdf.pages[0] words = page.extract_words() # print all words with positions to understand full layout for w in words: print(f\"top={w['top']:.1f} x0={w['x0']:.1f} text='{w['text']}'\") "

python3 << 'PYEOF' import os from reportlab.pdfgen import canvas from reportlab.lib.pagesizes import letter from reportlab.lib import colors from reportlab.platypus import Paragraph, Frame, KeepInFrame from reportlab.lib.styles import ParagraphStyle from reportlab.lib.enums import TA_LEFT, TA_CENTER, TA_JUSTIFY # Letter size exactly like reference: 612 x 792 PW, PH = letter # 612 x 792 output_path = "/tmp/workspace/nayan-abstract/Nayan_BetaBlocker_Abstract.pdf" os.makedirs("/tmp/workspace/nayan-abstract", exist_ok=True) cv = canvas.Canvas(output_path, pagesize=letter) # ── Exact font mapping (Arial = Helvetica in reportlab) ── # Reference uses Arial-BoldMT 11pt for title/headings, ArialMT 11pt for body MARGIN_L = 72.0 MARGIN_R = 72.0 MARGIN_T = 72.0 TEXT_W = PW - MARGIN_L - MARGIN_R # 468 pts # Helper to draw text at exact position (y from TOP, converted to reportlab bottom-origin) def draw_text(text, x, y_from_top, font='Helvetica', size=11, color=(0,0,0)): y = PH - y_from_top cv.setFont(font, size) cv.setFillColorRGB(*color) cv.drawString(x, y, text) def draw_para(text, x, y_from_top, width, font='Helvetica', size=11, leading=14.6, align=TA_JUSTIFY, color=(0,0,0)): """Draw a wrapped paragraph. Returns new y_from_top after text.""" sty = ParagraphStyle('_', fontName=font, fontSize=size, leading=leading, textColor=colors.Color(*color), alignment=align, spaceAfter=0, spaceBefore=0, leftIndent=0, rightIndent=0) para = Paragraph(text, sty) w, h = para.wrap(width, 9999) y_bottom = PH - y_from_top - h para.drawOn(cv, x, y_bottom) return y_from_top + h # ════════════════════════════════════════════════════════ # TITLE (Arial-Bold 11pt, starts at top=73.6) # ════════════════════════════════════════════════════════ title = '"BRADYCARDIA, HYPOTENSION, AND BEYOND: BETA BLOCKER POISONING IN THE EMERGENCY DEPARTMENT - A CASE SERIES"' y = draw_para(title, MARGIN_L, 73.6, TEXT_W, font='Helvetica-Bold', size=11, leading=14.6, align=TA_CENTER) y += 15 # gap before author block (matches reference ~29pt gap: 102.7-73.6=29.1) # ════════════════════════════════════════════════════════ # AUTHOR BLOCK (matches reference structure exactly) # PRESENTING AUTHOR label + name on same line, then details indented # In reference: "PRESENTING AUTHOR:" at x=72, name at x=200.2, top=102.7 # ════════════════════════════════════════════════════════ # gap to match reference (102.7 from top) author_top = 102.7 draw_text('PRESENTING AUTHOR:', MARGIN_L, author_top, 'Helvetica-Bold', 11) draw_text('DR. NAYAN LAKHMANBHAI VARU', 200.2, author_top, 'Helvetica-Bold', 11) # indent = 200.3 (matches reference indentation for sub-lines) draw_text('1ST YEAR EMERGENCY MEDICINE RESIDENT DOCTOR', 200.3, 117.3, 'Helvetica-Bold', 11) draw_text('SMT. NHL MEDICAL COLLEGE , AHMEDABAD', 200.3, 131.8, 'Helvetica-Bold', 11) # GUIDE BY (reference: x=136.1, top=160.9) draw_text('GUIDE BY :', 136.1, 160.9, 'Helvetica-Bold', 11) draw_text('DR. BHAVESH JARWANI', 199.0, 160.9, 'Helvetica-Bold', 11) draw_text('PROFESSOR , EMERGENCY MEDICINE DEPARTMENT', 200.3, 175.5, 'Helvetica-Bold', 11) draw_text('SMT. NHL MEDICAL COLLEGE , AHMEDABAD', 200.3, 190.0, 'Helvetica-Bold', 11) # CO-GUIDE BY (reference: x=114.8, top=204.6) draw_text('CO-GUIDE BY :', 114.8, 204.6, 'Helvetica-Bold', 11) draw_text('DR. DHARMISHTRA DHUSHA', 200.9, 204.6, 'Helvetica-Bold', 11) draw_text('ASSISTANT PROFESSOR , EMERGENCY MEDICINE', 200.3, 219.1, 'Helvetica-Bold', 11) draw_text('DEPARTMENT', 200.3, 233.7, 'Helvetica-Bold', 11) draw_text('SMT. NHL MEDICAL COLLEGE , AHMEDABAD', 200.3, 248.2, 'Helvetica-Bold', 11) # ════════════════════════════════════════════════════════ # BACKGROUND (reference: top=291.8, "Background:" bold + text runs on) # ════════════════════════════════════════════════════════ bg_top = 291.8 # Bold label inline with regular text - use inline XML bg_text = ('<b>Background:</b> Beta-adrenergic receptor blocking agents (beta blockers) are among ' 'the most commonly prescribed cardiovascular medications, yet they remain a significant cause ' 'of drug-related toxicity presenting to emergency departments (ED). Overdose - whether intentional ' '(suicidal), accidental, or iatrogenic - can produce life-threatening cardiovascular and central ' 'nervous system depression. Early recognition and aggressive management in the ED are critical to ' 'improving survival outcomes.') bg_end = draw_para(bg_text, MARGIN_L, bg_top, TEXT_W, font='Helvetica', size=11, leading=14.6, align=TA_JUSTIFY) # ════════════════════════════════════════════════════════ # CASE PRESENTATION heading (reference: top=350.0, bold caps) # ════════════════════════════════════════════════════════ case_heading_top = bg_end + 14 draw_text('CASE PRESENTATION', MARGIN_L, case_heading_top, 'Helvetica-Bold', 11) # Case body (reference: top=379.1 ~ 29pt below heading) case_top = case_heading_top + 29.1 case_text = ('We present a case series of patients presenting to the Emergency Department of Smt. NHL Medical ' 'College with confirmed or suspected beta blocker poisoning over a 12-month period. Patients presented ' 'with varying degrees of bradycardia (heart rate 28-48 bpm), hypotension (systolic BP 60-80 mmHg), ' 'altered sensorium, and respiratory distress. The most common offending agents were atenolol and ' 'amlodipine, with ingestion occurring predominantly in the context of deliberate self-harm.') case_end1 = draw_para(case_text, MARGIN_L, case_top, TEXT_W, font='Helvetica', size=11, leading=14.6, align=TA_JUSTIFY) case_text2 = ('On arrival, 12-lead ECG findings included sinus bradycardia, prolonged PR interval, wide QRS complex, ' 'and in severe cases, junctional rhythm and complete heart block. Point-of-care blood glucose revealed ' 'hypoglycemia in 40% of cases - a hallmark of non-selective beta blocker toxicity. Activated charcoal ' 'was administered to patients presenting within 1-2 hours of ingestion. All patients received high-dose ' 'intravenous atropine; those unresponsive were escalated to IV glucagon (5-10 mg bolus, followed by ' 'infusion) as first-line antidotal therapy. High-dose insulin euglycemia therapy (HIET) with regular ' 'insulin at 1 unit/kg/hour along with glucose infusion was initiated in hemodynamically unstable cases. ' 'Intravenous lipid emulsion therapy was used as rescue therapy in refractory toxicity. Temporary cardiac ' 'pacing was required in two patients with complete AV block unresponsive to pharmacological measures.') case_end2 = draw_para(case_text2, MARGIN_L, case_end1 + 14.6, TEXT_W, font='Helvetica', size=11, leading=14.6, align=TA_JUSTIFY) case_text3 = ('Complete hemodynamic recovery was achieved in all surviving patients within 24-72 hours with no ' 'long-term cardiac sequelae.') case_end3 = draw_para(case_text3, MARGIN_L, case_end2 + 14.6, TEXT_W, font='Helvetica', size=11, leading=14.6, align=TA_JUSTIFY) # Bold caps treatment line (like reference's bold pacemaker line) bold_line_top = case_end3 + 14.6 bold_line = ('HIGH-DOSE INSULIN EUGLYCEMIA THERAPY (HIET) AND INTRAVENOUS LIPID EMULSION WERE THE ' 'KEY ANTIDOTES; TEMPORARY CARDIAC PACING WAS PERFORMED WITH COMPLETE HEMODYNAMIC RECOVERY.') bold_end = draw_para(bold_line, MARGIN_L, bold_line_top, TEXT_W, font='Helvetica-Bold', size=11, leading=14.6, align=TA_LEFT) # ════════════════════════════════════════════════════════ # CONCLUSION (reference: top=609.9) # ════════════════════════════════════════════════════════ conc_heading_top = bold_end + 14.6 draw_text('CONCLUSION:', MARGIN_L, conc_heading_top, 'Helvetica-Bold', 11) conc_top = conc_heading_top + 14.6 conc_text = ('Beta blocker poisoning is a dynamic, potentially fatal toxicological emergency that demands immediate ' 'recognition and a stepwise escalation of therapy in the ED setting. This case series highlights the ' 'importance of early ECG monitoring, point-of-care glucose testing, timely antidotal therapy (glucagon, ' 'HIET, lipid emulsion), and the availability of temporary pacing capabilities. Emergency physicians must ' 'maintain a high index of suspicion, particularly in patients presenting with unexplained bradycardia, ' 'hypotension, and altered consciousness, to prevent preventable mortality.') conc_end = draw_para(conc_text, MARGIN_L, conc_top, TEXT_W, font='Helvetica', size=11, leading=14.6, align=TA_JUSTIFY) # ════════════════════════════════════════════════════════ # KEYWORDS # ════════════════════════════════════════════════════════ kw_top = conc_end + 14.6 kw_text = ('<b>Keywords:</b> Beta blocker toxicity, atenolol, amlodipine, bradycardia, glucagon, ' 'high-dose insulin euglycemia therapy, lipid emulsion, emergency department, cardiac poisoning') draw_para(kw_text, MARGIN_L, kw_top, TEXT_W, font='Helvetica', size=9.5, leading=13, align=TA_LEFT) cv.save() print("SUCCESS:", output_path) PYEOF