import subprocess, json, base64, requests
from io import BytesIO
from pptx import Presentation
from pptx.util import Inches, Pt, Emu
from pptx.dml.color import RGBColor
from pptx.enum.text import PP_ALIGN, MSO_ANCHOR

# ─── Color Palette ───
DARK_BLUE   = RGBColor(0x0D, 0x2B, 0x55)   # deep navy
MID_BLUE    = RGBColor(0x16, 0x5A, 0x8E)   # medium blue
ACCENT_TEAL = RGBColor(0x00, 0xA5, 0xAD)   # teal accent
LIGHT_GRAY  = RGBColor(0xF4, 0xF7, 0xFA)   # slide background
WHITE       = RGBColor(0xFF, 0xFF, 0xFF)
DARK_TEXT   = RGBColor(0x1A, 0x1A, 0x2E)
GOLD        = RGBColor(0xE8, 0xA8, 0x00)

# ─── Image URLs ───
IMG_URLS = [
    "https://cdn.orris.care/cdss_images/pmc_clinical_VQA_8c0f26b32ee3a313ede3dd75e267145e4ec29653e8d553d05a53829d5bbd3c44.jpg",
    "https://cdn.orris.care/cdss_images/pmc_clinical_VQA_1616af5d11ef1b569516dd5af8a448bee7288247a7dd779ec25814b7eb58d143.jpg",
    "https://cdn.orris.care/cdss_images/pmc_clinical_VQA_7cfd4e2cedd509661604877772acfd1e7a944a53303c49d87ded5488dbf144f9.jpg",
]

def download_image(url):
    try:
        r = requests.get(url, timeout=15)
        if r.status_code == 200:
            return BytesIO(r.content)
    except Exception as e:
        print(f"Image download failed: {e}")
    return None

# ─── Helper Functions ───
def add_colored_rect(slide, left, top, width, height, color):
    from pptx.util import Inches
    shape = slide.shapes.add_shape(1, left, top, width, height)
    shape.fill.solid()
    shape.fill.fore_color.rgb = color
    shape.line.fill.background()
    return shape

def add_text(slide, text, left, top, width, height,
             font_name="Calibri", font_size=16, bold=False, italic=False,
             color=DARK_TEXT, align=PP_ALIGN.LEFT, word_wrap=True, v_anchor=None):
    tb = slide.shapes.add_textbox(left, top, width, height)
    tf = tb.text_frame
    tf.word_wrap = word_wrap
    if v_anchor:
        tf.vertical_anchor = v_anchor
    tf.margin_left = 0; tf.margin_right = 0
    tf.margin_top = Pt(2); tf.margin_bottom = Pt(2)
    p = tf.paragraphs[0]
    p.alignment = align
    r = p.add_run()
    r.text = text
    r.font.name = font_name
    r.font.size = Pt(font_size)
    r.font.bold = bold
    r.font.italic = italic
    r.font.color.rgb = color
    return tf

def add_bullet_slide(prs, title_text, bullets, source_text="", img_stream=None, img_side="right"):
    blank = prs.slide_layouts[6]
    slide = prs.slides.add_slide(blank)
    W = prs.slide_width
    H = prs.slide_height

    # Background
    add_colored_rect(slide, 0, 0, W, H, LIGHT_GRAY)
    # Title bar
    add_colored_rect(slide, 0, 0, W, Inches(1.1), DARK_BLUE)
    # Accent stripe
    add_colored_rect(slide, 0, Inches(1.1), W, Inches(0.06), ACCENT_TEAL)

    # Title text
    add_text(slide, title_text, Inches(0.4), Inches(0.1), Inches(12.5), Inches(0.95),
             font_size=30, bold=True, color=WHITE, v_anchor=MSO_ANCHOR.MIDDLE)

    # Source label
    if source_text:
        add_text(slide, source_text, Inches(0.4), Inches(1.2), Inches(12.5), Inches(0.3),
                 font_size=10, italic=True, color=MID_BLUE)

    # Content area - with or without image
    content_left = Inches(0.4)
    content_width = Inches(12.5) if not img_stream else Inches(7.4)
    y = Inches(1.6)
    line_h = Inches(0.42)

    for bullet in bullets:
        if bullet.startswith("##"):  # subheader
            tb = slide.shapes.add_textbox(content_left, y, content_width, Inches(0.38))
            tf = tb.text_frame; tf.word_wrap = True
            tf.margin_left = 0; tf.margin_right = 0; tf.margin_top = 0; tf.margin_bottom = 0
            p = tf.paragraphs[0]
            r = p.add_run()
            r.text = bullet[2:].strip()
            r.font.name = "Calibri"; r.font.size = Pt(15)
            r.font.bold = True; r.font.color.rgb = MID_BLUE
            y += Inches(0.38)
        elif bullet.strip() == "":
            y += Inches(0.15)
        else:
            # bullet row
            # dot
            dot_tb = slide.shapes.add_textbox(content_left, y, Inches(0.25), line_h)
            dtf = dot_tb.text_frame; dtf.word_wrap = False
            dtf.margin_left = 0; dtf.margin_right = 0; dtf.margin_top = Pt(3); dtf.margin_bottom = 0
            dp = dtf.paragraphs[0]
            dr = dp.add_run(); dr.text = "►"
            dr.font.size = Pt(10); dr.font.color.rgb = ACCENT_TEAL; dr.font.bold = True

            # text
            btb = slide.shapes.add_textbox(content_left + Inches(0.28), y, content_width - Inches(0.28), line_h)
            btf = btb.text_frame; btf.word_wrap = True
            btf.margin_left = 0; btf.margin_right = 0; btf.margin_top = Pt(1); btf.margin_bottom = 0
            bp = btf.paragraphs[0]
            br = bp.add_run()
            parts = bullet.split("**")
            if len(parts) > 1:
                # bold-normal alternation
                for i, part in enumerate(parts):
                    if i == 0:
                        br.text = part
                        br.font.name = "Calibri"; br.font.size = Pt(14)
                        br.font.bold = False; br.font.color.rgb = DARK_TEXT
                    else:
                        nr = bp.add_run()
                        nr.text = part
                        nr.font.name = "Calibri"; nr.font.size = Pt(14)
                        nr.font.bold = (i % 2 == 1)
                        nr.font.color.rgb = DARK_BLUE if (i % 2 == 1) else DARK_TEXT
            else:
                br.text = bullet
                br.font.name = "Calibri"; br.font.size = Pt(14)
                br.font.bold = False; br.font.color.rgb = DARK_TEXT
            y += line_h

    # Image
    if img_stream:
        img_left = Inches(8.1)
        img_top  = Inches(1.55)
        img_w    = Inches(4.9)
        img_h    = Inches(5.5)
        try:
            slide.shapes.add_picture(img_stream, img_left, img_top, img_w, img_h)
        except Exception as e:
            print(f"Image embed failed: {e}")

    # Footer
    add_colored_rect(slide, 0, H - Inches(0.32), W, Inches(0.32), DARK_BLUE)
    add_text(slide, "Hemothorax | Surgical Perspective", Inches(0.4), H - Inches(0.32),
             Inches(8), Inches(0.3), font_size=9, color=WHITE)
    add_text(slide, "Bailey & Love's | Murray & Nadel's", W - Inches(4.5), H - Inches(0.32),
             Inches(4.3), Inches(0.3), font_size=9, color=RGBColor(0xAA, 0xCC, 0xFF),
             align=PP_ALIGN.RIGHT)

    return slide


# ─── TITLE SLIDE ───
def make_title_slide(prs):
    blank = prs.slide_layouts[6]
    slide = prs.slides.add_slide(blank)
    W = prs.slide_width; H = prs.slide_height

    # Full dark background
    add_colored_rect(slide, 0, 0, W, H, DARK_BLUE)
    # Bottom accent band
    add_colored_rect(slide, 0, H - Inches(1.8), W, Inches(0.08), ACCENT_TEAL)
    # Left side vertical accent
    add_colored_rect(slide, 0, 0, Inches(0.12), H, ACCENT_TEAL)

    # Main title
    tb = slide.shapes.add_textbox(Inches(0.5), Inches(1.6), Inches(12.5), Inches(2.2))
    tf = tb.text_frame; tf.word_wrap = True
    tf.margin_left = 0; tf.margin_right = 0; tf.margin_top = 0; tf.margin_bottom = 0
    p = tf.paragraphs[0]; p.alignment = PP_ALIGN.CENTER
    r = p.add_run(); r.text = "HEMOTHORAX"
    r.font.name = "Calibri"; r.font.size = Pt(56)
    r.font.bold = True; r.font.color.rgb = WHITE

    # Subtitle
    tb2 = slide.shapes.add_textbox(Inches(0.5), Inches(3.7), Inches(12.5), Inches(0.7))
    tf2 = tb2.text_frame; tf2.word_wrap = True
    tf2.margin_left = 0; tf2.margin_right = 0; tf2.margin_top = 0; tf2.margin_bottom = 0
    p2 = tf2.paragraphs[0]; p2.alignment = PP_ALIGN.CENTER
    r2 = p2.add_run(); r2.text = "Definition · Etiology · Diagnosis · Management · Complications"
    r2.font.name = "Calibri"; r2.font.size = Pt(20)
    r2.font.color.rgb = ACCENT_TEAL

    # Source line
    tb3 = slide.shapes.add_textbox(Inches(0.5), Inches(4.7), Inches(12.5), Inches(0.5))
    tf3 = tb3.text_frame; tf3.word_wrap = True
    tf3.margin_left = 0; tf3.margin_right = 0; tf3.margin_top = 0; tf3.margin_bottom = 0
    p3 = tf3.paragraphs[0]; p3.alignment = PP_ALIGN.CENTER
    r3 = p3.add_run()
    r3.text = "Based on: Bailey & Love's Short Practice of Surgery (28th Ed.)  |  Murray & Nadel's Textbook of Respiratory Medicine"
    r3.font.name = "Calibri"; r3.font.size = Pt(13)
    r3.font.italic = True; r3.font.color.rgb = RGBColor(0xAA, 0xCC, 0xFF)

    # Note about SRB
    tb4 = slide.shapes.add_textbox(Inches(0.5), Inches(5.5), Inches(12.5), Inches(0.4))
    tf4 = tb4.text_frame; tf4.word_wrap = True
    tf4.margin_left = 0; tf4.margin_right = 0; tf4.margin_top = 0; tf4.margin_bottom = 0
    p4 = tf4.paragraphs[0]; p4.alignment = PP_ALIGN.CENTER
    r4 = p4.add_run()
    r4.text = "Note: SRB's Textbook of Surgery is not in the available library; content is sourced from Bailey & Love's and Murray & Nadel's"
    r4.font.name = "Calibri"; r4.font.size = Pt(11)
    r4.font.italic = True; r4.font.color.rgb = GOLD

    # Footer bar
    add_colored_rect(slide, 0, H - Inches(0.32), W, Inches(0.32), MID_BLUE)


# ─── SECTION DIVIDER SLIDE ───
def make_section_slide(prs, section_title, subtitle=""):
    blank = prs.slide_layouts[6]
    slide = prs.slides.add_slide(blank)
    W = prs.slide_width; H = prs.slide_height

    add_colored_rect(slide, 0, 0, W, H, MID_BLUE)
    add_colored_rect(slide, 0, H//2 - Inches(0.05), W, Inches(0.08), ACCENT_TEAL)

    tb = slide.shapes.add_textbox(Inches(1), Inches(2.2), Inches(11), Inches(1.5))
    tf = tb.text_frame; tf.word_wrap = True
    tf.margin_left = 0; tf.margin_right = 0; tf.margin_top = 0; tf.margin_bottom = 0
    p = tf.paragraphs[0]; p.alignment = PP_ALIGN.CENTER
    r = p.add_run(); r.text = section_title
    r.font.name = "Calibri"; r.font.size = Pt(42)
    r.font.bold = True; r.font.color.rgb = WHITE

    if subtitle:
        tb2 = slide.shapes.add_textbox(Inches(1), Inches(3.8), Inches(11), Inches(0.6))
        tf2 = tb2.text_frame; tf2.word_wrap = True
        tf2.margin_left = 0; tf2.margin_right = 0
        p2 = tf2.paragraphs[0]; p2.alignment = PP_ALIGN.CENTER
        r2 = p2.add_run(); r2.text = subtitle
        r2.font.name = "Calibri"; r2.font.size = Pt(18)
        r2.font.italic = True; r2.font.color.rgb = RGBColor(0xCC, 0xEA, 0xFF)

    add_colored_rect(slide, 0, H - Inches(0.32), W, Inches(0.32), DARK_BLUE)


# ─── BUILD PRESENTATION ───
prs = Presentation()
prs.slide_width  = Inches(13.333)
prs.slide_height = Inches(7.5)

# Download images
print("Downloading images...")
imgs = [download_image(u) for u in IMG_URLS]
print(f"Downloaded {sum(1 for i in imgs if i)} / {len(imgs)} images")

# 1. TITLE
make_title_slide(prs)

# 2. DEFINITION & OVERVIEW
add_bullet_slide(prs,
    "Definition & Overview",
    [
        "**Hemothorax** is the accumulation of blood within the pleural space",
        "Diagnosed when pleural fluid hematocrit is **>50% of peripheral blood hematocrit**",
        "Due to significant color change with even small amounts of blood — fluid analysis is essential to confirm",
        "Etiology is broadly classified as: **Traumatic, Nontraumatic,** and **Iatrogenic**",
        "Nearly **300,000 cases** of traumatic hemothorax occur in the United States each year",
        "Can lead to significant hemodynamic instability due to hypovolemia",
    ],
    source_text="Source: Murray & Nadel's Textbook of Respiratory Medicine; Bailey & Love's Short Practice of Surgery 28th Ed."
)

# 3. ETIOLOGY - Traumatic
make_section_slide(prs, "ETIOLOGY", "Traumatic | Nontraumatic | Iatrogenic")

add_bullet_slide(prs,
    "Etiology: Traumatic Hemothorax",
    [
        "**Most common cause** of hemothorax overall",
        "**Blunt trauma:** torn intercostal vessels, lung, diaphragm, great vessels, or mediastinal structures",
        "Common mechanisms: motor vehicle collisions, falls",
        "**Penetrating trauma:** gunshot or stab wounds — often clinically significant",
        "**Rib fractures** strongly associated — >5 rib fractures → **≥48% likelihood** of concomitant hemothorax",
        "In blunt trauma series: **2.4%** had hemothorax; in penetrating trauma: **83%** had concomitant pneumothorax",
        "**Bailey & Love's:** In blunt injury — torn intercostal vessels or internal mammary artery from rib fractures",
        "In penetrating injury — thoracic and abdominal viscera (blood through diaphragm into negative-pressure thorax)",
    ],
    source_text="Sources: Murray & Nadel's; Bailey & Love's 28th Ed.",
    img_stream=imgs[0]
)

add_bullet_slide(prs,
    "Etiology: Nontraumatic & Iatrogenic",
    [
        "## Nontraumatic (Spontaneous)",
        "Spontaneous pneumothorax — **most common** cause of nontraumatic hemothorax",
        "Hemothorax develops in **2–7%** of spontaneous pneumothorax cases",
        "Mechanism: torn adhesions between visceral and parietal pleura or rupture of vascularised bullae",
        "**Vascular pathology:** aortic dissection (usually left-sided), pulmonary AVM (hereditary haemorrhagic telangiectasia)",
        "**Neoplasms:** schwannoma, soft tissue tumors, pleural metastases (rare)",
        "**Endometriosis:** thoracic endometriosis syndrome — 14% of cases; typically **right-sided** in young women",
        "",
        "## Iatrogenic",
        "Thoracentesis (overall risk ~0.01%), pleural/lung biopsies, vascular catheterization",
        "Anticoagulation therapy, cardiopulmonary resuscitation, post-thoracic surgery",
    ],
    source_text="Source: Murray & Nadel's Textbook of Respiratory Medicine"
)

# 4. DIAGNOSIS
make_section_slide(prs, "DIAGNOSIS", "Clinical Features · Imaging · Investigations")

add_bullet_slide(prs,
    "Clinical Features & Diagnosis",
    [
        "## Clinical Suspicion",
        "Any patient with **chest trauma** (penetrating or blunt), recent invasive thoracic procedure, or **unexplained pleural effusion in a hypotensive patient**",
        "## Physical Examination",
        "Asymmetric chest expansion",
        "Diminished or absent breath sounds (unilateral)",
        "**Dullness to percussion** (differs from pneumothorax — which is hyperresonant)",
        "**Haemorrhagic shock:** hypotension, tachycardia, flat neck veins — Bailey & Love's",
        "Sensitivity of exam findings increases with size of effusion",
        "## Investigations",
        "Pleural fluid hematocrit **>50%** of peripheral hematocrit confirms diagnosis",
        "Empyema ruled out by pH, glucose, LDH, culture",
    ],
    source_text="Sources: Murray & Nadel's; Bailey & Love's 28th Ed."
)

add_bullet_slide(prs,
    "Imaging in Hemothorax",
    [
        "## Chest Radiograph (CXR)",
        "Initial imaging modality of choice",
        "Lateral decubitus CXR — most sensitive plain film; detects as little as **10 mL**",
        "AP upright film: requires ~**200 mL** for costophrenic angle blunting",
        "Supine film may only show uniform haziness — can miss large volumes",
        "Hemidiaphragm obscured at **500–650 mL**; mediastinal shift away from effusion",
        "## CT Scan",
        "**Gold standard** for detection and quantification of hemothorax",
        "Detects occult hemothorax not visible on plain film",
        "Identifies associated injuries (rib fractures, pulmonary contusion, pneumothorax)",
        "## Ultrasound (FAST/eFAST)",
        "Rapid bedside evaluation — identifies pleural fluid superior to diaphragm",
        "Used in initial trauma assessment alongside CXR — Bailey & Love's recommends **eFAST**",
    ],
    source_text="Sources: Murray & Nadel's; Bailey & Love's 28th Ed.",
    img_stream=imgs[2]
)

# 5. MANAGEMENT
make_section_slide(prs, "MANAGEMENT", "Drainage · Surgery · Indications")

add_bullet_slide(prs,
    "Management: Principles & Chest Drainage",
    [
        "**First-line treatment:** Pleural drainage — tube thoracostomy",
        "EAST guidelines: drain all hemothoraces irrespective of presumed volume",
        "Updated EAST 2020: clinical judgment may be applied for **small hemothoraces (<300 mL)**",
        "**'Stein line':** meniscus on upright CXR — 200–300 mL; patients below this may be expectantly managed",
        "## Tube Thoracostomy (Intercostal Drain)",
        "Classic recommendation: **large-bore (32–40 French)** tube",
        "Recent evidence: **14-French pigtail catheters** non-inferior to large-bore tubes for drainage",
        "Optimal position: 'Triangle of Safety' with suction — equivalent drainage regardless of location",
        "## Bailey & Love's Key Points",
        "Initial treatment: correct hypovolaemic shock + insert intercostal drain + intubation if needed",
        "Blood should be removed **as completely and rapidly as possible**",
        "**No role for clamping** a chest tube to tamponade massive haemothorax",
    ],
    source_text="Sources: Murray & Nadel's; Bailey & Love's 28th Ed.",
    img_stream=imgs[1]
)

add_bullet_slide(prs,
    "Massive Haemothorax: Bailey & Love's",
    [
        "Defined as: **>1500 mL initial drainage** or **ongoing haemorrhage >200 mL/hour over 3–4 hours**",
        "## Presentation",
        "Haemorrhagic shock (hypotension, tachycardia)",
        "Flat neck veins (distinguishes from cardiac tamponade)",
        "Unilateral absence of breath sounds + dullness to percussion",
        "Compromises respiratory effort by compressing the lung",
        "## Initial Management",
        "Correct hypovolaemic shock (IV access, blood products, fluids)",
        "Insert intercostal drain (chest tube)",
        "Intubation as required",
        "## Indications for Urgent Thoracotomy",
        "Initial drainage **>1500 mL**",
        "Ongoing haemorrhage **>200 mL/h for 3–4 hours**",
        "Haemodynamic instability not responding to resuscitation",
    ],
    source_text="Source: Bailey & Love's Short Practice of Surgery, 28th Edition — Chapter: Thoracic Trauma"
)

add_bullet_slide(prs,
    "Surgical Intervention",
    [
        "## Video-Assisted Thoracoscopic Surgery (VATS)",
        "Appropriate for **haemodynamically stable** patients",
        "Used for: retained haemothorax, clot evacuation, pleurodesis",
        "## Open Thoracotomy",
        "Preferred in **haemodynamically unstable** patients",
        "Position: **lateral decubitus**",
        "Approach: **posterolateral** through 4th or 5th interspace",
        "Interspace/incision type adapted based on clot location",
        "## Transcatheter Arterial Embolization",
        "For intercostal artery hemorrhage in **poor surgical candidates**",
        "~90% still require surgical intervention following embolization",
        "Increased failure risk with: severe anaemia, chronic liver failure, embolization of ≥2 arteries",
        "## Bailey & Love's: Monitoring",
        "Chest radiograph or eFAST to identify blood",
        "If lung does not reinflate: place drain on low-pressure suction (5 cmH₂O)",
        "Physiotherapy and active mobilisation as soon as possible",
    ],
    source_text="Sources: Murray & Nadel's; Bailey & Love's 28th Ed."
)

# 6. COMPLICATIONS
make_section_slide(prs, "COMPLICATIONS", "Retained Haemothorax · Empyema · Fibrothorax")

add_bullet_slide(prs,
    "Complications of Hemothorax",
    [
        "## Retained Haemothorax",
        "Occurs in **~30%** of patients despite chest tube placement",
        "Defined as haemothorax that persists despite attempted drainage",
        "Increases risk of empyema, trapped lung, and need for surgery",
        "## Empyema",
        "Incidence up to **26%** in retained haemothorax (prospective multicenter study, n=328)",
        "Risk factors: haemothorax volume >300 mL, bilateral chest tubes, pulmonary contusion, rib fractures, prolonged ICU stay",
        "Management: appropriate drainage; decortication if required",
        "## Pneumonia",
        "Documented in **20%** of patients with retained haemothorax",
        "Risk factors: age >55, blunt trauma, concomitant pneumothorax, no empiric antibiotics at tube insertion",
        "## Fibrothorax / Trapped Lung",
        "Historically feared complication of delayed management",
        "Current evidence: retained haemothorax **NOT** an independent risk factor for fibrothorax",
        "Fibrothorax more likely due to **poor or delayed empyema management**",
        "Bailey & Love's: removal of blood prevents ongoing bleeding, empyema, and fibrothorax",
    ],
    source_text="Sources: Murray & Nadel's; Bailey & Love's 28th Ed."
)

# 7. SUMMARY SLIDE
add_bullet_slide(prs,
    "Summary",
    [
        "**Definition:** Blood in pleural space; hematocrit >50% of peripheral blood",
        "**Most common cause:** Trauma (blunt > penetrating); 300,000 cases/year in USA",
        "**Nontraumatic causes:** Spontaneous pneumothorax, vascular pathology, neoplasm, endometriosis",
        "**Diagnosis:** Clinical features + CXR (initial) + CT scan (gold standard) + eFAST (bedside)",
        "**First-line treatment:** Tube thoracostomy / intercostal drain",
        "**Massive haemothorax:** >1500 mL drainage or >200 mL/h x 3–4 hrs → urgent thoracotomy",
        "**Complications:** Retained haemothorax, empyema (26%), pneumonia (20%), fibrothorax",
        "**Surgery:** VATS (stable) or open thoracotomy (unstable) via posterolateral approach",
        "**Key Bailey & Love's point:** No role for clamping chest tube; remove blood completely and rapidly",
    ],
    source_text="Sources: Bailey & Love's Short Practice of Surgery (28th Ed.) | Murray & Nadel's Textbook of Respiratory Medicine"
)

# ─── SAVE ───
out_path = "/tmp/workspace/hemothorax-ppt/Hemothorax_Presentation.pptx"
prs.save(out_path)
print(f"\nSaved: {out_path}")
print(f"Total slides: {len(prs.slides)}")