Urolithiasis - Renal & Ureteric Stones: Complete Notes

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

# ── Colour palette ──────────────────────────────────────────────────────────
NAVY      = HexColor("#1a2a4a")
TEAL      = HexColor("#1d7a8c")
TEAL_LIGHT= HexColor("#e8f4f7")
AMBER     = HexColor("#e8a020")
AMBER_LT  = HexColor("#fff8ee")
RED_BRICK = HexColor("#c0392b")
RED_LT    = HexColor("#fdf2f2")
GREY_DARK = HexColor("#444444")
GREY_MID  = HexColor("#888888")
GREY_LT   = HexColor("#f5f5f5")
WHITE     = colors.white

PAGE_W, PAGE_H = A4  # 595 x 842 pt

# ── Styles ───────────────────────────────────────────────────────────────────
base_styles = getSampleStyleSheet()

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

COVER_TITLE = S("CoverTitle", fontName="Helvetica-Bold", fontSize=30,
                textColor=WHITE, alignment=TA_CENTER, leading=38)
COVER_SUB   = S("CoverSub",   fontName="Helvetica",      fontSize=13,
                textColor=HexColor("#cce8ef"), alignment=TA_CENTER, leading=18)
COVER_BADGE = S("CoverBadge", fontName="Helvetica-Bold", fontSize=10,
                textColor=AMBER, alignment=TA_CENTER)

SECTION_HDR = S("SectionHdr", fontName="Helvetica-Bold", fontSize=11,
                textColor=WHITE, alignment=TA_LEFT, leading=15)
BODY        = S("Body",        fontName="Helvetica",      fontSize=8.5,
                textColor=GREY_DARK, leading=13, spaceAfter=3)
BODY_BOLD   = S("BodyBold",    fontName="Helvetica-Bold", fontSize=8.5,
                textColor=NAVY, leading=13)
BULLET      = S("Bullet",      fontName="Helvetica",      fontSize=8.5,
                textColor=GREY_DARK, leading=13, leftIndent=12,
                firstLineIndent=0, spaceAfter=2)
BULLET2     = S("Bullet2",     fontName="Helvetica",      fontSize=8,
                textColor=GREY_DARK, leading=12, leftIndent=24,
                firstLineIndent=0, spaceAfter=1)
WARN_TXT    = S("WarnTxt",     fontName="Helvetica-Bold", fontSize=8.5,
                textColor=RED_BRICK, leading=13)
NOTE_TXT    = S("NoteTxt",     fontName="Helvetica-Oblique", fontSize=8,
                textColor=HexColor("#555555"), leading=12)
TABLE_HDR   = S("TblHdr",      fontName="Helvetica-Bold", fontSize=8,
                textColor=WHITE, alignment=TA_CENTER, leading=11)
TABLE_CELL  = S("TblCell",     fontName="Helvetica",      fontSize=7.5,
                textColor=GREY_DARK, leading=11)
TABLE_CELL_B= S("TblCellB",    fontName="Helvetica-Bold", fontSize=7.5,
                textColor=NAVY, leading=11)
PAGE_NUM    = S("PageNum",     fontName="Helvetica",      fontSize=7.5,
                textColor=GREY_MID, alignment=TA_CENTER)


# ── Helper Flowables ──────────────────────────────────────────────────────────
class SectionHeader(Flowable):
    """Coloured banner with white text for a section heading."""
    def __init__(self, text, bg=NAVY, width=None, height=18):
        super().__init__()
        self.text   = text
        self.bg     = bg
        self._width = width
        self.height = height

    def wrap(self, avail_w, avail_h):
        self.draw_w = self._width or avail_w
        return self.draw_w, self.height + 4

    def draw(self):
        c = self.canv
        c.setFillColor(self.bg)
        c.roundRect(0, 0, self.draw_w, self.height, 3, fill=1, stroke=0)
        c.setFillColor(WHITE)
        c.setFont("Helvetica-Bold", 9.5)
        c.drawString(6, 4.5, self.text)


class ColourBox(Flowable):
    """Shaded box that wraps a list of flowables visually."""
    def __init__(self, content_height, width=None, bg=TEAL_LIGHT, radius=4):
        super().__init__()
        self.content_height = content_height
        self._width  = width
        self.bg      = bg
        self.radius  = radius

    def wrap(self, avail_w, avail_h):
        self.draw_w = self._width or avail_w
        return self.draw_w, self.content_height

    def draw(self):
        c = self.canv
        c.setFillColor(self.bg)
        c.roundRect(0, 0, self.draw_w, self.content_height,
                    self.radius, fill=1, stroke=0)


def bp(text, indent=0):
    prefix = "  " * indent
    sym = "•" if indent == 0 else "–"
    style = BULLET if indent == 0 else BULLET2
    return Paragraph(f"{prefix}{sym}  {text}", style)


def p(text, style=BODY):
    return Paragraph(text, style)


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


def hr(color=TEAL, thickness=0.6):
    return HRFlowable(width="100%", thickness=thickness, color=color,
                      spaceAfter=4, spaceBefore=4)


# ── Two-column page layout ────────────────────────────────────────────────────
COL_GAP   = 10 * mm
MARGIN    = 16 * mm
COL_W     = (PAGE_W - 2 * MARGIN - COL_GAP) / 2   # ≈ 250 pt

def make_table_data(headers, rows, col_widths):
    """Build a styled ReportLab table."""
    header_row = [Paragraph(h, TABLE_HDR) for h in headers]
    data = [header_row]
    for row in rows:
        data.append([Paragraph(str(c), TABLE_CELL) for c in row])
    t = Table(data, colWidths=col_widths)
    style = TableStyle([
        ("BACKGROUND",  (0,0), (-1,0),  NAVY),
        ("ROWBACKGROUNDS",(0,1),(-1,-1),[GREY_LT, WHITE]),
        ("GRID",        (0,0), (-1,-1), 0.4, HexColor("#cccccc")),
        ("TOPPADDING",  (0,0), (-1,-1), 4),
        ("BOTTOMPADDING",(0,0),(-1,-1), 4),
        ("LEFTPADDING", (0,0), (-1,-1), 5),
        ("RIGHTPADDING",(0,0), (-1,-1), 5),
        ("VALIGN",      (0,0), (-1,-1), "MIDDLE"),
    ])
    t.setStyle(style)
    return t


# ── Build content columns ─────────────────────────────────────────────────────
def build_left_col():
    """Returns a list of flowables for the LEFT column of each spread."""
    items = []

    # ─ Section 1: Aetiology ──────────────────────────────────────
    items.append(SectionHeader("1  AETIOLOGY — Drivers of Calculus Formation", NAVY, COL_W))
    items.append(sp(5))

    cats = [
        ("Mechanical / Structural", TEAL,
         ["PUJ (Pelviureteric Junction) obstruction → urinary stasis"]),
        ("Environmental / Dietary", AMBER,
         ["Hot climate → excessive sweating → concentrated urine",
          "Specific dietary triggers (e.g. coffee)"]),
        ("Systemic / Metabolic", NAVY,
         ["Hyperparathyroidism (→ hypercalcaemia)",
          "Vitamin A deficiency → desquamation of urinary epithelium"]),
        ("Infectious / Lifestyle", RED_BRICK,
         ["Prolonged immobilisation",
          "Urease-splitting bacterial infections"]),
    ]

    for title, col, bullets in cats:
        items.append(SectionHeader(title, col, COL_W, height=15))
        items.append(sp(2))
        for b in bullets:
            items.append(bp(b))
        items.append(sp(4))

    items.append(sp(8))

    # ─ Section 2: Stone Types (radiopaque) ───────────────────────
    items.append(SectionHeader("2  STONE TYPOLOGY — Radiopaque Calculi", NAVY, COL_W))
    items.append(sp(5))

    items.append(make_table_data(
        ["Stone Type", "Crystal Shape", "pH", "Key Risk Factors"],
        [
            ["Calcium Oxalate\n(Most common)", "Envelope-shaped", "Acid", "Hypercalcaemia\nHypercalciuria\nHyperuricosuria"],
            ["Struvite\n(Staghorn)", "Coffin-lid /\nRectangular", "Alkaline", "Urea-splitting\norganisms\n(e.g. Proteus)"],
            ["Calcium Phosphate", "—", "Alkaline", "Hypercalcaemia"],
        ],
        [COL_W*0.28, COL_W*0.22, COL_W*0.12, COL_W*0.38]
    ))
    items.append(sp(6))

    # ─ Section 3: Stone Types (rare / radiolucent) ───────────────
    items.append(SectionHeader("3  STONE TYPOLOGY — Rare & Radiolucent Variants", TEAL, COL_W))
    items.append(sp(5))

    items.append(make_table_data(
        ["Stone", "Radio-opacity", "pH", "Key Notes"],
        [
            ["Cystine", "Radiopaque\n(rare)", "Acid", "Hexagonal crystals\nHard — NOT broken by ESWL"],
            ["Uric Acid", "Radiolucent", "Acid", "Associated with Gout"],
            ["Xanthine", "Radiolucent", "—", "Brick-red colour"],
            ["Drug-induced", "Radiolucent", "—", "Indinavir, triamterene etc."],
        ],
        [COL_W*0.22, COL_W*0.18, COL_W*0.10, COL_W*0.50]
    ))
    items.append(sp(6))

    return items


def build_right_col():
    """Returns a list of flowables for the RIGHT column of each spread."""
    items = []

    # ─ Section 4: Obstruction / Dietl Crisis ─────────────────────
    items.append(SectionHeader("4  OBSTRUCTION MECHANICS & CLINICAL FEATURES", NAVY, COL_W))
    items.append(sp(5))

    items.append(SectionHeader("Dietl Crisis — Total Pelvic Obstruction", TEAL, COL_W, height=15))
    items.append(sp(3))
    steps = [
        "Urine stops draining from renal pelvis → ureter.",
        "Urine accumulates → massive distension of kidney capsule.",
        "Patient presents with severe flank pain + swelling.",
        "<b>Resolution:</b> Stone shifts → urine flows out → swelling subsides → patient passes large quantities of <b>dilute urine</b>.",
    ]
    for i, s in enumerate(steps, 1):
        items.append(p(f"<b>{i}.</b>  {s}"))
    items.append(sp(6))

    items.append(SectionHeader("Physical Examination Signs", TEAL, COL_W, height=15))
    items.append(sp(3))
    items.append(bp("<b>Renal angle (CVA) tenderness</b>"))
    items.append(bp("<b>Bimanual ballottement</b> — specifically in hydronephrosis"))
    items.append(sp(8))

    # ─ Section 5: Investigations ─────────────────────────────────
    items.append(SectionHeader("5  DIAGNOSTIC INVESTIGATION PATHWAY", NAVY, COL_W))
    items.append(sp(5))

    items.append(p("<b>Step 1 — Baseline Pathology</b>"))
    items.append(bp("Urine: RME (Routine Microscopic Examination)"))
    items.append(bp("Blood: Sugar, Electrolytes, Creatinine"))
    items.append(sp(4))

    items.append(p("<b>Step 2 — Primary Imaging</b>"))
    items.append(make_table_data(
        ["Modality", "Notes / Limitations"],
        [
            ["X-ray KUB", "Identifies radiopaque shadows; combine with MCC + PVR"],
            ["USG KUB", "First-line. NOT sensitive for lower ureter — bowel gas obscures view"],
        ],
        [COL_W*0.30, COL_W*0.70]
    ))
    items.append(sp(5))

    items.append(SectionHeader("Investigation of Choice (IOC): NCCT KUB", RED_BRICK, COL_W, height=15))
    items.append(sp(3))
    items.append(p("<b>Non-Contrast CT Abdomen & Pelvis</b>"))
    items.append(sp(2))
    items.append(p("⚠  <b>Why NON-contrast?</b>", WARN_TXT))
    items.append(p("Contrast dye is nephrotoxic. A patient with renal obstruction is "
                   "already at risk of AKI — contrast exacerbates this."))
    items.append(sp(3))
    items.append(p("<b>Secondary option — IVU (Intravenous Urogram):</b>"))
    items.append(p("Strictly reserved for cases where serum creatinine is "
                   "<b>verified as normal</b> (no underlying kidney damage)."))
    items.append(sp(5))

    items.append(p("<i>Always differentiate calculi from a calcified foreign body on imaging.</i>", NOTE_TXT))
    items.append(sp(8))

    # ─ Section 6: Management ─────────────────────────────────────
    items.append(SectionHeader("6  MANAGEMENT — Surgical Escalation Ladder", NAVY, COL_W))
    items.append(sp(5))

    ladder = [
        ("1", "Conservative / Symptom Control",
         ["Analgesics — primary acute pain control",
          "Antibiotics — infection prevention & treatment",
          "Antiulcerants — GI protection"]),
        ("2", "ESWL — Extracorporeal Shock Wave Lithotripsy", []),
        ("3", "PCNL — Percutaneous Nephrolithotomy", []),
        ("4", "RIRS — Retrograde Intrarenal Surgery", []),
        ("5", "Pyelolithotomy (open)\n  Technique: clamp renal artery → remove stone → unclamp", []),
        ("6", "Nephrectomy — end of line; severe/non-salvageable cases only", []),
    ]
    for num, title, subs in ladder:
        items.append(p(f"<b>Step {num}:</b>  {title}"))
        for s in subs:
            items.append(bp(s, indent=1))
        items.append(sp(3))

    items.append(sp(8))

    # ─ Section 7: ESWL detail ────────────────────────────────────
    items.append(SectionHeader("7  ESWL — Detail", TEAL, COL_W))
    items.append(sp(5))

    items.append(p("<b>Procedure:</b>  Blast-wave dynamics. Ultrasonic waves via "
                   "<b>Dornier apparatus</b> shatter stone → fragments pass down ureter. "
                   "Patient must remain <b>perfectly still</b>."))
    items.append(sp(5))

    items.append(p("<b>Contraindications:</b>"))
    contras = [
        "Pregnancy",
        "Uncontrolled bleeding disorders",
        "Stones <b>&gt; 1.5 cm</b> in size",
        "Cardiac pacemaker",
        "Children (cannot remain still)",
        "Obese patients (ultrasound wave delivery impaired)",
        "Very hard stones (Cystine or Calcium Oxalate Monohydrate)",
    ]
    for c in contras:
        items.append(bp(c))
    items.append(sp(5))

    items.append(p("<b>Complications:</b>"))
    items.append(bp("<b>Pain</b> — most common; often with haematuria"))
    items.append(bp("<b>Steinstrasse</b> ('stone street') — fragments from a large "
                    "shattered stone clog the ureter simultaneously → secondary "
                    "obstruction requiring further intervention"))
    items.append(sp(8))

    # ─ Section 8: MET + Ureteric stone ──────────────────────────
    items.append(SectionHeader("8  URETERIC STONE — MET & Intervention", NAVY, COL_W))
    items.append(sp(5))

    items.append(SectionHeader("First-Line: Medical Expulsive Therapy (MET)", TEAL, COL_W, height=15))
    items.append(sp(3))
    items.append(make_table_data(
        ["Drug Class", "Example", "Mechanism"],
        [
            ["Alpha-blocker", "Tamsulosin", "Relaxes ureteric smooth muscle"],
            ["Antispasmodic", "—", "Reduces ureteric spasm"],
            ["Diuretic", "—", "Promotes urine flow"],
            ["Antiulcerant", "—", "GI protection"],
        ],
        [COL_W*0.30, COL_W*0.25, COL_W*0.45]
    ))
    items.append(sp(5))

    items.append(SectionHeader("Second-Line: Intervention (if MET fails)", AMBER, COL_W, height=15))
    items.append(sp(3))
    items.append(p("<b>Endoscopic:</b>"))
    items.append(bp("Laser Lithotripsy"))
    items.append(bp("ICPL (Intracorporeal Pneumatic Lithotripsy)"))
    items.append(bp("Dormia Basket — used with ICPL for stone extraction"))
    items.append(sp(4))
    items.append(p("<b>Surgical:</b>"))
    items.append(bp("Ureterolithotomy (open or laparoscopic)"))
    items.append(sp(6))

    items.append(SectionHeader("DDx — Always Rule Out", RED_BRICK, COL_W, height=15))
    items.append(sp(3))
    items.append(bp("<b>Musculoskeletal pain</b>"))
    items.append(bp("<b>PLID</b> — Prolapsed Lumbar Intervertebral Disc"))

    return items


# ── PDF canvas callback (page template) ──────────────────────────────────────
def draw_page(canvas_obj, doc):
    canvas_obj.saveState()
    w, h = PAGE_W, PAGE_H

    # Top banner
    canvas_obj.setFillColor(NAVY)
    canvas_obj.rect(0, h - 28, w, 28, fill=1, stroke=0)
    canvas_obj.setFillColor(WHITE)
    canvas_obj.setFont("Helvetica-Bold", 10)
    canvas_obj.drawString(MARGIN, h - 18, "UROLITHIASIS")
    canvas_obj.setFont("Helvetica", 8)
    canvas_obj.setFillColor(HexColor("#aaccdd"))
    canvas_obj.drawRightString(w - MARGIN, h - 18,
                                "Renal & Ureteric Stones — Clinical Reference")

    # Vertical divider between columns
    mid_x = MARGIN + COL_W + COL_GAP / 2
    canvas_obj.setStrokeColor(HexColor("#cccccc"))
    canvas_obj.setLineWidth(0.5)
    canvas_obj.line(mid_x, 30, mid_x, h - 32)

    # Left label
    canvas_obj.setFillColor(TEAL)
    canvas_obj.setFont("Helvetica-Bold", 7)
    canvas_obj.drawString(MARGIN, h - 36, "◀  LEFT")

    # Right label
    canvas_obj.drawRightString(w - MARGIN, h - 36, "RIGHT  ▶")

    # Bottom bar
    canvas_obj.setFillColor(GREY_LT)
    canvas_obj.rect(0, 0, w, 22, fill=1, stroke=0)
    canvas_obj.setFillColor(GREY_MID)
    canvas_obj.setFont("Helvetica", 7)
    canvas_obj.drawCentredString(w / 2, 7,
        f"Page {doc.page}  |  Urolithiasis Clinical Pathway Dossier")

    canvas_obj.restoreState()


def draw_cover(canvas_obj, doc):
    """Full bleed navy cover page."""
    canvas_obj.saveState()
    w, h = PAGE_W, PAGE_H

    # Background gradient effect (two rects)
    canvas_obj.setFillColor(NAVY)
    canvas_obj.rect(0, 0, w, h, fill=1, stroke=0)
    canvas_obj.setFillColor(HexColor("#0d1f3c"))
    canvas_obj.rect(0, 0, w, h / 2, fill=1, stroke=0)

    # Decorative teal bar
    canvas_obj.setFillColor(TEAL)
    canvas_obj.rect(0, h * 0.55, w, 6, fill=1, stroke=0)

    # Kidney icon placeholder (circle)
    canvas_obj.setFillColor(HexColor("#1d5a6c"))
    canvas_obj.circle(w / 2, h * 0.70, 55, fill=1, stroke=0)
    canvas_obj.setFillColor(TEAL)
    canvas_obj.circle(w / 2, h * 0.70, 50, fill=0, stroke=1)
    canvas_obj.setStrokeColor(TEAL)
    canvas_obj.setLineWidth(1.5)

    # Title
    canvas_obj.setFillColor(WHITE)
    canvas_obj.setFont("Helvetica-Bold", 28)
    canvas_obj.drawCentredString(w / 2, h * 0.48, "UROLITHIASIS")
    canvas_obj.setFont("Helvetica-Bold", 14)
    canvas_obj.setFillColor(HexColor("#cce8ef"))
    canvas_obj.drawCentredString(w / 2, h * 0.43, "Renal & Ureteric Stones")

    # Sub-tagline
    canvas_obj.setFont("Helvetica", 10)
    canvas_obj.setFillColor(HexColor("#99bbcc"))
    canvas_obj.drawCentredString(w / 2, h * 0.385,
                                  "Complete Clinical Reference Blueprint")
    canvas_obj.drawCentredString(w / 2, h * 0.360,
                                  "Aetiology  ·  Diagnostics  ·  Management")

    # Badge
    canvas_obj.setFillColor(AMBER)
    canvas_obj.roundRect(w/2 - 80, h*0.29, 160, 22, 5, fill=1, stroke=0)
    canvas_obj.setFillColor(NAVY)
    canvas_obj.setFont("Helvetica-Bold", 9)
    canvas_obj.drawCentredString(w / 2, h * 0.298,
                                  "Clinical Pathway Dossier")

    # Topics list
    topics = ["Stone Types & Typology Matrix",
              "Obstruction Mechanics & Dietl Crisis",
              "Diagnostic Pathway: USG → NCCT",
              "Surgical Escalation Ladder",
              "ESWL: Procedure, CI & Complications",
              "Medical Expulsive Therapy (MET)",
              "DDx: MSK Pain & PLID"]
    y = h * 0.22
    canvas_obj.setFont("Helvetica", 8.5)
    canvas_obj.setFillColor(HexColor("#aaddee"))
    for t in topics:
        canvas_obj.drawCentredString(w / 2, y, f"✦  {t}")
        y -= 14

    # Footer
    canvas_obj.setFillColor(TEAL)
    canvas_obj.rect(0, 0, w, 30, fill=1, stroke=0)
    canvas_obj.setFillColor(WHITE)
    canvas_obj.setFont("Helvetica", 8)
    canvas_obj.drawCentredString(w / 2, 10, "Clinical Notes Booklet  |  Left–Right Spread Format")

    canvas_obj.restoreState()


# ── Assemble the document ─────────────────────────────────────────────────────
OUT = "/home/daytona/workspace/urolithiasis-booklet/Urolithiasis_Booklet.pdf"

from reportlab.platypus import BaseDocTemplate, PageTemplate, Frame, NextPageTemplate, PageBreak

# Two frames: left column and right column
left_frame = Frame(
    MARGIN, 35,
    COL_W, PAGE_H - 35 - 45,
    leftPadding=0, rightPadding=0,
    topPadding=0, bottomPadding=0,
    id="left"
)
right_frame = Frame(
    MARGIN + COL_W + COL_GAP, 35,
    COL_W, PAGE_H - 35 - 45,
    leftPadding=0, rightPadding=0,
    topPadding=0, bottomPadding=0,
    id="right"
)

# Cover frame
cover_frame = Frame(0, 0, PAGE_W, PAGE_H,
                    leftPadding=0, rightPadding=0,
                    topPadding=0, bottomPadding=0,
                    id="cover")

doc = BaseDocTemplate(
    OUT,
    pagesize=A4,
    rightMargin=0, leftMargin=0, topMargin=0, bottomMargin=0,
)

cover_template = PageTemplate(id="Cover", frames=[cover_frame],
                               onPage=draw_cover)
spread_template = PageTemplate(id="Spread", frames=[left_frame, right_frame],
                                onPage=draw_page)
doc.addPageTemplates([cover_template, spread_template])

# ── Story ─────────────────────────────────────────────────────────────────────
story = []

# Cover page (empty — drawn purely on canvas)
story.append(NextPageTemplate("Cover"))
story.append(Spacer(1, PAGE_H))   # fill the cover frame with nothing

# Switch to spread template
story.append(NextPageTemplate("Spread"))
story.append(PageBreak())

# Pour left-column content first; ReportLab will flow right when left overflows
left  = build_left_col()
right = build_right_col()

for f in left:
    story.append(f)

# Force jump to right column / next page
story.append(PageBreak())   # end of left column → right column

for f in right:
    story.append(f)

doc.build(story)
print(f"PDF written → {OUT}")

Successfully replaced 1 instance(s) of the string in '/home/daytona/workspace/urolithiasis-booklet/build_booklet.py'

Successfully replaced 1 instance(s) of the string in '/home/daytona/workspace/urolithiasis-booklet/build_booklet.py'

Successfully replaced 1 instance(s) of the string in '/home/daytona/workspace/urolithiasis-booklet/build_booklet.py'