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
from pptx.util import Inches, Pt
import io

# ─── Color Palette ───────────────────────────────────────────────────
DARK_BLUE   = RGBColor(0x0A, 0x29, 0x5C)   # deep navy
MED_BLUE    = RGBColor(0x1A, 0x5E, 0xA8)   # medium blue
ACCENT_TEAL = RGBColor(0x00, 0xA8, 0xA8)   # teal accent
LIGHT_BG    = RGBColor(0xEE, 0xF4, 0xFF)   # very light blue
WHITE       = RGBColor(0xFF, 0xFF, 0xFF)
DARK_TEXT   = RGBColor(0x1A, 0x1A, 0x2E)
ORANGE_ACC  = RGBColor(0xE8, 0x65, 0x00)
GREEN_ACC   = RGBColor(0x0A, 0x7A, 0x3A)
GRAY_LIGHT  = RGBColor(0xD0, 0xDA, 0xEC)

prs = Presentation()
prs.slide_width  = Inches(13.333)
prs.slide_height = Inches(7.5)
blank = prs.slide_layouts[6]

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

def add_rect(slide, x, y, w, h, fill_color=None, line_color=None, line_width=None):
    shape = slide.shapes.add_shape(1, Inches(x), Inches(y), Inches(w), Inches(h))
    if fill_color:
        shape.fill.solid()
        shape.fill.fore_color.rgb = fill_color
    else:
        shape.fill.background()
    if line_color:
        shape.line.color.rgb = line_color
        if line_width:
            shape.line.width = Pt(line_width)
    else:
        shape.line.fill.background()
    return shape

def add_text(slide, text, x, y, w, h, font_name="Calibri", font_size=18,
             bold=False, italic=False, color=DARK_TEXT, align=PP_ALIGN.LEFT,
             wrap=True, v_anchor=MSO_ANCHOR.TOP):
    tb = slide.shapes.add_textbox(Inches(x), Inches(y), Inches(w), Inches(h))
    tf = tb.text_frame
    tf.word_wrap = wrap
    tf.vertical_anchor = v_anchor
    tf.margin_left = Pt(4)
    tf.margin_right = Pt(4)
    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_multiline(slide, lines, x, y, w, h, font_name="Calibri", font_size=16,
                  bold=False, color=DARK_TEXT, align=PP_ALIGN.LEFT,
                  bullet=True, line_spacing=1.15):
    tb = slide.shapes.add_textbox(Inches(x), Inches(y), Inches(w), Inches(h))
    tf = tb.text_frame
    tf.word_wrap = True
    tf.margin_left = Pt(6)
    tf.margin_right = Pt(4)
    tf.margin_top = Pt(2)
    tf.margin_bottom = Pt(2)
    from pptx.util import Pt as UPt
    from pptx.oxml.ns import qn
    import lxml.etree as etree

    for i, line in enumerate(lines):
        p = tf.paragraphs[0] if i == 0 else tf.add_paragraph()
        p.alignment = align
        # space between lines
        p.line_spacing = line_spacing
        if bullet:
            p.space_before = Pt(3)
        r = p.add_run()
        prefix = "• " if bullet else ""
        r.text = prefix + line
        r.font.name = font_name
        r.font.size = Pt(font_size)
        r.font.bold = bold
        r.font.color.rgb = color
    return tf

def add_heading_bar(slide, title, subtitle=None):
    """Full-width dark blue header bar."""
    add_rect(slide, 0, 0, 13.333, 1.1, fill_color=DARK_BLUE)
    add_text(slide, title, 0.3, 0.08, 10, 0.8,
             font_size=30, bold=True, color=WHITE, align=PP_ALIGN.LEFT,
             v_anchor=MSO_ANCHOR.MIDDLE)
    if subtitle:
        add_text(slide, subtitle, 0.3, 0.75, 11, 0.4,
                 font_size=14, italic=True, color=ACCENT_TEAL, align=PP_ALIGN.LEFT)

def add_footer(slide, text="Knee MUA – Clinical Presentation"):
    add_rect(slide, 0, 7.2, 13.333, 0.3, fill_color=DARK_BLUE)
    add_text(slide, text, 0.3, 7.22, 12, 0.26,
             font_size=9, color=GRAY_LIGHT, align=PP_ALIGN.LEFT)

# ══════════════════════════════════════════════════════════════════════
# SLIDE 1 – TITLE SLIDE
# ══════════════════════════════════════════════════════════════════════
s1 = prs.slides.add_slide(blank)

# Full gradient-style background: dark navy
add_rect(s1, 0, 0, 13.333, 7.5, fill_color=DARK_BLUE)

# Accent stripe
add_rect(s1, 0, 0, 0.5, 7.5, fill_color=ACCENT_TEAL)
add_rect(s1, 0.5, 5.5, 12.833, 0.06, fill_color=ACCENT_TEAL)

# Title
add_text(s1, "Knee Manipulation Under Anesthesia", 1.2, 1.5, 11, 1.4,
         font_name="Calibri", font_size=44, bold=True, color=WHITE,
         align=PP_ALIGN.LEFT, v_anchor=MSO_ANCHOR.MIDDLE)

# Subtitle
add_text(s1, "Trust, Technique & Therapeutic Outcomes", 1.2, 3.0, 10, 0.8,
         font_name="Calibri", font_size=26, bold=False, color=ACCENT_TEAL,
         align=PP_ALIGN.LEFT, v_anchor=MSO_ANCHOR.MIDDLE)

# Tagline
add_text(s1, "A comprehensive clinical guide for physiotherapists and orthopaedic professionals",
         1.2, 3.85, 10, 0.6,
         font_name="Calibri", font_size=15, italic=True, color=GRAY_LIGHT,
         align=PP_ALIGN.LEFT)

# Bottom info
add_text(s1, "Source: Clinical Case Notes + Video Demonstration (Dr. Prateek Joshi)",
         1.2, 6.5, 11, 0.5,
         font_name="Calibri", font_size=12, color=GRAY_LIGHT,
         align=PP_ALIGN.LEFT)

# ══════════════════════════════════════════════════════════════════════
# SLIDE 2 – WHAT IS MUA?
# ══════════════════════════════════════════════════════════════════════
s2 = prs.slides.add_slide(blank)
add_rect(s2, 0, 0, 13.333, 7.5, fill_color=LIGHT_BG)
add_heading_bar(s2, "What is Manipulation Under Anesthesia (MUA)?")
add_footer(s2)

# Definition box
add_rect(s2, 0.4, 1.3, 12.5, 1.4, fill_color=MED_BLUE, line_color=DARK_BLUE, line_width=0)
add_text(s2,
         "MUA is a non-invasive procedure performed under anesthesia to break up scar tissue and fibrous "
         "adhesions that restrict joint movement — restoring range of motion in a stiff knee.",
         0.55, 1.35, 12.2, 1.3,
         font_size=17, bold=False, color=WHITE, wrap=True,
         v_anchor=MSO_ANCHOR.MIDDLE)

# Two-column info
col1_lines = [
    "Increases range of motion in a stiff knee joint",
    "Breaks intra-articular fibrous adhesions and scar tissue",
    "Non-invasive — no surgical incision required",
    "Same-day outpatient procedure (30–60 minutes)",
    "Typically performed under general anesthesia or regional block",
]
col2_lines = [
    "Post-fracture surgery stiffness",
    "Post-Total Knee Arthroplasty (TKA) stiffness",
    "Arthrofibrosis",
    "Failed conservative physiotherapy",
    "ROM < functional threshold (usually < 90° flexion)",
]

add_rect(s2, 0.4, 2.85, 5.9, 0.35, fill_color=DARK_BLUE)
add_text(s2, "Key Features", 0.55, 2.87, 5.5, 0.3,
         font_size=13, bold=True, color=WHITE)

add_rect(s2, 7.0, 2.85, 6.0, 0.35, fill_color=ACCENT_TEAL)
add_text(s2, "Indications", 7.15, 2.87, 5.5, 0.3,
         font_size=13, bold=True, color=WHITE)

add_multiline(s2, col1_lines, 0.4, 3.25, 6.0, 3.8,
              font_size=14, color=DARK_TEXT, bullet=True)
add_multiline(s2, col2_lines, 7.0, 3.25, 6.0, 3.8,
              font_size=14, color=DARK_TEXT, bullet=True)

# ══════════════════════════════════════════════════════════════════════
# SLIDE 3 – CLINICAL CASE
# ══════════════════════════════════════════════════════════════════════
s3 = prs.slides.add_slide(blank)
add_rect(s3, 0, 0, 13.333, 7.5, fill_color=LIGHT_BG)
add_heading_bar(s3, "Clinical Case Presentation", "Real-world example from handwritten clinical notes")
add_footer(s3)

# Patient profile card
add_rect(s3, 0.4, 1.25, 5.5, 5.9, fill_color=WHITE, line_color=MED_BLUE, line_width=1.5)
add_rect(s3, 0.4, 1.25, 5.5, 0.45, fill_color=MED_BLUE)
add_text(s3, "Patient Profile", 0.6, 1.27, 5.0, 0.4,
         font_size=14, bold=True, color=WHITE)

patient_details = [
    "Age: 35 years old, Male",
    "Presentation: Knee stiffness",
    "Duration: 3 months post-surgery",
    "Prior surgery: Fracture of proximal tibia",
    "Pre-MUA ROM: 0° – 95° flexion",
    "Functional threshold not yet met",
]
add_multiline(s3, patient_details, 0.5, 1.75, 5.2, 4.8,
              font_size=14, color=DARK_TEXT, bullet=True)

# Pathophysiology card
add_rect(s3, 6.5, 1.25, 6.4, 5.9, fill_color=WHITE, line_color=ACCENT_TEAL, line_width=1.5)
add_rect(s3, 6.5, 1.25, 6.4, 0.45, fill_color=ACCENT_TEAL)
add_text(s3, "Why MUA Was Needed", 6.7, 1.27, 5.8, 0.4,
         font_size=14, bold=True, color=WHITE)

path_details = [
    "Post-fracture fixation leads to immobilization",
    "Immobilization → dense collagen scar tissue forms",
    "Adhesions develop in joint capsule and recesses",
    "Mechanical block prevents flexion beyond 95°",
    "Conservative physiotherapy had limited gains",
    "Patient had difficulty with daily activities",
    "MUA indicated to break adhesions safely",
]
add_multiline(s3, path_details, 6.6, 1.75, 6.1, 5.0,
              font_size=13.5, color=DARK_TEXT, bullet=True)

# ══════════════════════════════════════════════════════════════════════
# SLIDE 4 – ROLE OF ANESTHESIA & PATIENT TRUST
# ══════════════════════════════════════════════════════════════════════
s4 = prs.slides.add_slide(blank)
add_rect(s4, 0, 0, 13.333, 7.5, fill_color=LIGHT_BG)
add_heading_bar(s4, "Role of Anesthesia & Building Patient Trust")
add_footer(s4)

# Why anesthesia box
add_rect(s4, 0.4, 1.25, 5.8, 5.9, fill_color=WHITE, line_color=MED_BLUE, line_width=1.5)
add_rect(s4, 0.4, 1.25, 5.8, 0.45, fill_color=MED_BLUE)
add_text(s4, "Why Anesthesia is Essential", 0.6, 1.27, 5.4, 0.4,
         font_size=14, bold=True, color=WHITE)

anesthesia_lines = [
    "Eliminates pain during the procedure",
    "Achieves complete muscle relaxation",
    "Removes protective muscle guarding",
    "Allows therapist to apply controlled force",
    "Prevents involuntary patient movement",
    "General anesthesia OR regional block (femoral nerve / epidural)",
    "Patient is comfortable and unaware during manipulation",
]
add_multiline(s4, anesthesia_lines, 0.5, 1.75, 5.5, 5.2,
              font_size=13.5, color=DARK_TEXT, bullet=True)

# Trust box
add_rect(s4, 6.8, 1.25, 6.1, 5.9, fill_color=WHITE, line_color=ORANGE_ACC, line_width=1.5)
add_rect(s4, 6.8, 1.25, 6.1, 0.45, fill_color=ORANGE_ACC)
add_text(s4, "Patient Trust: Why It Matters", 7.0, 1.27, 5.7, 0.4,
         font_size=14, bold=True, color=WHITE)

trust_lines = [
    "Many patients fear MUA after seeing aggressive online videos",
    "Trust begins with clear, honest informed consent",
    "Show the patient that technique is gentle — not forceful",
    "Explain every step in the patient's language",
    "Address fear of re-injury or permanent damage",
    "Demonstrate expected post-op ROM improvement",
    "Reassure about post-procedure physiotherapy plan",
    "Shared decision-making builds compliance",
]
add_multiline(s4, trust_lines, 6.9, 1.75, 5.8, 5.0,
              font_size=13.5, color=DARK_TEXT, bullet=True)

# ══════════════════════════════════════════════════════════════════════
# SLIDE 5 – PROCEDURE TECHNIQUE (STEP BY STEP)
# ══════════════════════════════════════════════════════════════════════
s5 = prs.slides.add_slide(blank)
add_rect(s5, 0, 0, 13.333, 7.5, fill_color=LIGHT_BG)
add_heading_bar(s5, "Step-by-Step Technique: The Right Way to Perform MUA")
add_footer(s5)

steps = [
    ("1", "Positioning",     "Patient supine. Pelvis stabilized. Contralateral limb secured to isolate the affected knee."),
    ("2", "Stabilize Femur", "Therapist firmly holds the femur to prevent compensatory hip rotation or pelvic tilt."),
    ("3", "Grip the Tibia",  "Both hands + forearm grasp the FULL length of the tibia — distributes force evenly."),
    ("4", "Begin Flexion",   "Gradually push tibia posteriorly using body weight — smooth, controlled, no jerky motion."),
    ("5", "Break Adhesions", "Audible/palpable 'pops' occur as intra-articular fibrous adhesions tear gently."),
    ("6", "Check ROM",       "Assess range achieved. Target: 110°–125° flexion and full 0° extension."),
]

step_colors = [MED_BLUE, ACCENT_TEAL, MED_BLUE, ACCENT_TEAL, MED_BLUE, ACCENT_TEAL]

for idx, (num, title, desc) in enumerate(steps):
    row = idx // 2
    col = idx % 2
    x = 0.4 + col * 6.5
    y = 1.3 + row * 2.05
    add_rect(s5, x, y, 6.1, 1.85, fill_color=WHITE, line_color=step_colors[idx], line_width=1.5)
    add_rect(s5, x, y, 0.65, 1.85, fill_color=step_colors[idx])
    add_text(s5, num, x + 0.05, y + 0.45, 0.55, 0.9,
             font_size=22, bold=True, color=WHITE, align=PP_ALIGN.CENTER, v_anchor=MSO_ANCHOR.MIDDLE)
    add_text(s5, title, x + 0.75, y + 0.08, 5.1, 0.45,
             font_size=14, bold=True, color=step_colors[idx])
    add_text(s5, desc, x + 0.75, y + 0.55, 5.1, 1.1,
             font_size=13, color=DARK_TEXT, wrap=True)

# ══════════════════════════════════════════════════════════════════════
# SLIDE 6 – GENTLE vs AGGRESSIVE TECHNIQUE
# ══════════════════════════════════════════════════════════════════════
s6 = prs.slides.add_slide(blank)
add_rect(s6, 0, 0, 13.333, 7.5, fill_color=LIGHT_BG)
add_heading_bar(s6, "Gentle vs. Aggressive Technique — What the Video Teaches Us")
add_footer(s6)

# Gentle column
add_rect(s6, 0.4, 1.25, 5.8, 5.9, fill_color=WHITE, line_color=GREEN_ACC, line_width=2)
add_rect(s6, 0.4, 1.25, 5.8, 0.5, fill_color=GREEN_ACC)
add_text(s6, "✓  Gentle / Controlled Technique", 0.6, 1.28, 5.4, 0.45,
         font_size=14, bold=True, color=WHITE)

gentle_lines = [
    "Slow, sustained, progressive force",
    "Low-velocity, high-amplitude mobilization",
    "Therapist uses body weight — not arm strength",
    "Full tibial grip for even force distribution",
    "Avoids jerky or sudden movements",
    "Reduces risk of ligament injury",
    "Patient shows smooth ROM immediately after",
    "Achieves 0°–125° in the demonstrated case",
]
add_multiline(s6, gentle_lines, 0.5, 1.85, 5.5, 5.1,
              font_size=13.5, color=GREEN_ACC, bullet=True)

# Aggressive column
add_rect(s6, 7.1, 1.25, 5.8, 5.9, fill_color=WHITE, line_color=ORANGE_ACC, line_width=2)
add_rect(s6, 7.1, 1.25, 5.8, 0.5, fill_color=ORANGE_ACC)
add_text(s6, "✗  Aggressive / Forceful Technique", 7.3, 1.28, 5.4, 0.45,
         font_size=14, bold=True, color=WHITE)

aggressive_lines = [
    "High-velocity, jerky, uncontrolled force",
    "Only distal ankle/foot gripped — poor lever",
    "No body weight — excessive arm force used",
    "Increases ligament injury risk significantly",
    "Can cause periprosthetic / supracondylar fracture",
    "Risk of patellar tendon rupture",
    "Severe hemarthrosis (joint bleeding) possible",
    "Damages patient trust and worsens outcome",
]
add_multiline(s6, aggressive_lines, 7.2, 1.85, 5.5, 5.1,
              font_size=13.5, color=ORANGE_ACC, bullet=True)

# vs divider
add_rect(s6, 6.3, 2.5, 0.7, 3.0, fill_color=LIGHT_BG)
add_text(s6, "VS", 6.3, 3.7, 0.7, 0.7,
         font_size=18, bold=True, color=DARK_BLUE, align=PP_ALIGN.CENTER, v_anchor=MSO_ANCHOR.MIDDLE)

# ══════════════════════════════════════════════════════════════════════
# SLIDE 7 – IMMEDIATE OUTCOMES
# ══════════════════════════════════════════════════════════════════════
s7 = prs.slides.add_slide(blank)
add_rect(s7, 0, 0, 13.333, 7.5, fill_color=LIGHT_BG)
add_heading_bar(s7, "Immediate Clinical Outcomes — What We Achieved")
add_footer(s7)

# Before box
add_rect(s7, 0.4, 1.3, 3.9, 5.7, fill_color=WHITE, line_color=ORANGE_ACC, line_width=2)
add_rect(s7, 0.4, 1.3, 3.9, 0.5, fill_color=ORANGE_ACC)
add_text(s7, "BEFORE MUA", 0.6, 1.32, 3.5, 0.45,
         font_size=16, bold=True, color=WHITE, align=PP_ALIGN.CENTER)
before_lines = [
    "ROM: 0° – 95° flexion only",
    "Stiff, restricted movement",
    "Mechanical block from adhesions",
    "Pain with attempted flexion",
    "Difficulty with daily activities",
    "3 months post-fracture surgery",
]
add_multiline(s7, before_lines, 0.5, 1.9, 3.6, 4.8,
              font_size=13.5, color=DARK_TEXT, bullet=True)

# Arrow
add_text(s7, "→", 4.4, 3.5, 1.0, 1.0,
         font_size=48, bold=True, color=MED_BLUE, align=PP_ALIGN.CENTER)

# After box
add_rect(s7, 5.5, 1.3, 3.9, 5.7, fill_color=WHITE, line_color=GREEN_ACC, line_width=2)
add_rect(s7, 5.5, 1.3, 3.9, 0.5, fill_color=GREEN_ACC)
add_text(s7, "AFTER MUA", 5.7, 1.32, 3.5, 0.45,
         font_size=16, bold=True, color=WHITE, align=PP_ALIGN.CENTER)
after_lines = [
    "ROM: 0° – 125° flexion achieved",
    "Smooth, fluid movement",
    "Adhesions broken — joint freed",
    "Immediate gain of 30° flexion",
    "Patient can begin physiotherapy",
    "Functional ROM target met",
]
add_multiline(s7, after_lines, 5.6, 1.9, 3.6, 4.8,
              font_size=13.5, color=DARK_TEXT, bullet=True)

# Key message box
add_rect(s7, 9.6, 1.3, 3.5, 5.7, fill_color=DARK_BLUE)
add_text(s7, "Key Clinical\nMessage", 9.75, 1.4, 3.2, 0.8,
         font_size=15, bold=True, color=ACCENT_TEAL, align=PP_ALIGN.CENTER)
key_lines = [
    "30° immediate gain",
    "Smooth motion visible right after procedure",
    "Gains are TEMPORARY without follow-up PT",
    "Start physiotherapy SAME DAY if possible",
    "CPM machine may be prescribed",
    "Continue PT for several weeks",
]
add_multiline(s7, key_lines, 9.7, 2.25, 3.3, 4.5,
              font_size=12.5, color=WHITE, bullet=True)

# ══════════════════════════════════════════════════════════════════════
# SLIDE 8 – POST-MUA PHYSIOTHERAPY PROTOCOL
# ══════════════════════════════════════════════════════════════════════
s8 = prs.slides.add_slide(blank)
add_rect(s8, 0, 0, 13.333, 7.5, fill_color=LIGHT_BG)
add_heading_bar(s8, "Post-MUA Physiotherapy Protocol — 3-Phase Rehabilitation")
add_footer(s8)

phases = [
    ("Phase 1\nWeeks 0–2", "Protection & Edema Control",
     ["Start ROM exercises same day", "Passive → Active-assisted ROM",
      "Patellar mobilizations", "Quad/hamstring sets", "Heel slides",
      "Ice after exercises", "Hinged knee brace if prescribed"],
     MED_BLUE),
    ("Phase 2\nWeeks 2–4", "Strengthening & ROM Gains",
     ["Aggressive full ROM exercises", "Progress cycling, elliptical",
      "Straight-leg raises", "Hip/core strengthening",
      "Tibio-femoral distraction PROM", "Ultrasound / TENS as needed",
      "Reduce swelling monitoring"],
     ACCENT_TEAL),
    ("Phase 3\nWeeks 4–12", "Function & Return to Activity",
     ["Full weight-bearing activities", "Sport-specific exercises",
      "Balance and proprioception training", "Return to work assessment",
      "Maintain core, glutes, balance", "Driving clearance by consultant",
      "Long-term ROM maintenance plan"],
     GREEN_ACC),
]

for idx, (phase, title, items, color) in enumerate(phases):
    x = 0.4 + idx * 4.3
    add_rect(s8, x, 1.3, 4.05, 5.9, fill_color=WHITE, line_color=color, line_width=2)
    add_rect(s8, x, 1.3, 4.05, 1.0, fill_color=color)
    add_text(s8, phase, x + 0.15, 1.33, 3.7, 0.55,
             font_size=15, bold=True, color=WHITE, align=PP_ALIGN.CENTER)
    add_text(s8, title, x + 0.15, 1.9, 3.7, 0.35,
             font_size=12, italic=True, color=WHITE, align=PP_ALIGN.CENTER)
    add_multiline(s8, items, x + 0.1, 2.35, 3.8, 4.7,
                  font_size=12.5, color=DARK_TEXT, bullet=True)

# Critical warning
add_rect(s8, 0.4, 7.0, 12.5, 0.2, fill_color=ORANGE_ACC)
add_text(s8,
         "⚠  Without continued physiotherapy, scar tissue WILL re-form and the knee will become stiff again!",
         0.5, 6.95, 12.3, 0.25,
         font_size=11, bold=True, color=DARK_BLUE, align=PP_ALIGN.CENTER)

# ══════════════════════════════════════════════════════════════════════
# SLIDE 9 – COMPLICATIONS & SAFETY
# ══════════════════════════════════════════════════════════════════════
s9 = prs.slides.add_slide(blank)
add_rect(s9, 0, 0, 13.333, 7.5, fill_color=LIGHT_BG)
add_heading_bar(s9, "Risks, Complications & How to Minimize Them")
add_footer(s9)

risks = [
    ("Ligament Injury",       "Jerky or forceful manipulation — use controlled body-weight technique"),
    ("Periprosthetic Fracture", "Excessive force in TKA cases — assess bone quality pre-procedure"),
    ("Supracondylar Fracture",  "Aggressive levering — always hold full tibial length"),
    ("Patellar Tendon Rupture", "Forced hyperflexion — monitor tension and stop if resistance spikes"),
    ("Hemarthrosis",            "Micro-tears in joint capsule — ice, compression, elevation post-op"),
    ("Anesthesia Risks",        "Standard GA/regional block risks — managed by anesthesiology team"),
    ("Stiffness Recurrence",   "Failure to start PT early — begin physiotherapy same day post-MUA"),
]

add_rect(s9, 0.4, 1.25, 4.5, 0.4, fill_color=DARK_BLUE)
add_text(s9, "Complication", 0.55, 1.27, 4.2, 0.35, font_size=13, bold=True, color=WHITE)
add_rect(s9, 4.95, 1.25, 7.95, 0.4, fill_color=MED_BLUE)
add_text(s9, "Prevention / Management", 5.1, 1.27, 7.6, 0.35, font_size=13, bold=True, color=WHITE)

row_colors = [WHITE, LIGHT_BG]
for i, (risk, mgmt) in enumerate(risks):
    y = 1.7 + i * 0.77
    bg = row_colors[i % 2]
    add_rect(s9, 0.4, y, 4.5, 0.72, fill_color=bg, line_color=GRAY_LIGHT, line_width=0.5)
    add_rect(s9, 4.95, y, 7.95, 0.72, fill_color=bg, line_color=GRAY_LIGHT, line_width=0.5)
    add_text(s9, risk, 0.55, y + 0.04, 4.2, 0.65, font_size=13, bold=True, color=ORANGE_ACC)
    add_text(s9, mgmt, 5.1, y + 0.04, 7.6, 0.65, font_size=13, color=DARK_TEXT, wrap=True)

# ══════════════════════════════════════════════════════════════════════
# SLIDE 10 – KEY TAKEAWAYS
# ══════════════════════════════════════════════════════════════════════
s10 = prs.slides.add_slide(blank)
add_rect(s10, 0, 0, 13.333, 7.5, fill_color=DARK_BLUE)
add_rect(s10, 0, 0, 0.6, 7.5, fill_color=ACCENT_TEAL)
add_rect(s10, 0.6, 1.3, 12.733, 0.05, fill_color=ACCENT_TEAL)

add_text(s10, "Key Takeaways", 1.0, 0.2, 11, 1.0,
         font_size=38, bold=True, color=WHITE, align=PP_ALIGN.LEFT)

takeaways = [
    ("MUA is Effective", "It converts a restricted 0°–95° knee to a functional 0°–125° in a single procedure."),
    ("Technique is Everything", "Gentle, body-weight-driven, full-tibial-grip technique is safe. Jerky force is dangerous."),
    ("Anesthesia Enables Success", "Complete muscle relaxation is the foundation — without it, manipulation is painful and incomplete."),
    ("Trust is Non-Negotiable", "Informed consent, honest communication, and showing a gentle technique builds patient confidence."),
    ("PT Starts Day 1", "Gains are lost without immediate, aggressive physiotherapy. Start same day — continue for weeks."),
    ("Education Prevents Recurrence", "Patients must understand: stiffness WILL return without consistent exercise. Empower them."),
]

tk_colors = [ACCENT_TEAL, MED_BLUE, ACCENT_TEAL, MED_BLUE, ACCENT_TEAL, MED_BLUE]

for i, (title, body) in enumerate(takeaways):
    row = i // 2
    col = i % 2
    x = 0.8 + col * 6.3
    y = 1.5 + row * 1.9
    add_rect(s10, x, y, 5.8, 1.65, fill_color=RGBColor(0x0E, 0x3B, 0x7A),
             line_color=tk_colors[i], line_width=1.5)
    add_rect(s10, x, y, 0.12, 1.65, fill_color=tk_colors[i])
    add_text(s10, title, x + 0.25, y + 0.1, 5.4, 0.4,
             font_size=14, bold=True, color=tk_colors[i])
    add_text(s10, body, x + 0.25, y + 0.52, 5.35, 1.0,
             font_size=12.5, color=WHITE, wrap=True)

# Footer credit
add_text(s10,
         "Based on: Clinical Case Notes (Handwritten) + Video Demonstration by Dr. Prateek Joshi | AAOS Guidelines",
         0.8, 7.1, 12, 0.35,
         font_size=10, italic=True, color=GRAY_LIGHT)

# ══════════════════════════════════════════════════════════════════════
# SAVE
# ══════════════════════════════════════════════════════════════════════
out_path = "/tmp/workspace/knee-mua-presentation/Knee_MUA_Presentation.pptx"
prs.save(out_path)
print(f"Saved: {out_path}")

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

doc = Document()

# ── Page margins ──────────────────────────────────────────────────────
section = doc.sections[0]
section.page_width  = Inches(8.5)
section.page_height = Inches(11)
section.top_margin    = Inches(1.0)
section.bottom_margin = Inches(1.0)
section.left_margin   = Inches(1.2)
section.right_margin  = Inches(1.2)

# ── Default body font ─────────────────────────────────────────────────
normal = doc.styles["Normal"]
normal.font.name = "Calibri"
normal.font.size = Pt(11)

# ── Helper: set paragraph shading ─────────────────────────────────────
def shade_paragraph(para, hex_color):
    pPr = para._p.get_or_add_pPr()
    shd = OxmlElement("w:shd")
    shd.set(qn("w:val"), "clear")
    shd.set(qn("w:color"), "auto")
    shd.set(qn("w:fill"), hex_color)
    pPr.append(shd)

def set_para_border_bottom(para, hex_color="0A295C", sz="6"):
    pPr = para._p.get_or_add_pPr()
    pBdr = OxmlElement("w:pBdr")
    bottom = OxmlElement("w:bottom")
    bottom.set(qn("w:val"), "single")
    bottom.set(qn("w:sz"), sz)
    bottom.set(qn("w:space"), "1")
    bottom.set(qn("w:color"), hex_color)
    pBdr.append(bottom)
    pPr.append(pBdr)

def add_colored_run(para, text, bold=False, color_rgb=None, size=None, italic=False):
    run = para.add_run(text)
    run.bold = bold
    run.italic = italic
    if color_rgb:
        run.font.color.rgb = RGBColor(*color_rgb)
    if size:
        run.font.size = Pt(size)
    return run

# ══════════════════════════════════════════════════════════════════════
# HEADER BLOCK
# ══════════════════════════════════════════════════════════════════════

# Institution line
inst = doc.add_paragraph()
inst.alignment = WD_ALIGN_PARAGRAPH.CENTER
add_colored_run(inst, "CLINICAL CASE FILE", bold=True,
                color_rgb=(10, 41, 92), size=9)
shade_paragraph(inst, "EEF4FF")

doc.add_paragraph()  # spacer

# ── MAIN TITLE ────────────────────────────────────────────────────────
title_para = doc.add_heading("", level=0)
title_para.clear()
title_para.alignment = WD_ALIGN_PARAGRAPH.CENTER
add_colored_run(title_para,
                "Knee Manipulation Under Anesthesia",
                bold=True, color_rgb=(10, 41, 92), size=22)
shade_paragraph(title_para, "0A295C")

# Subtitle bar
sub_para = doc.add_paragraph()
sub_para.alignment = WD_ALIGN_PARAGRAPH.CENTER
shade_paragraph(sub_para, "1A5EA8")
add_colored_run(sub_para,
                "A Procedure Done to Increase the Range of Motion of a Stiff Knee Joint",
                italic=True, color_rgb=(255, 255, 255), size=12)

doc.add_paragraph()  # spacer

# ── Meta info table ───────────────────────────────────────────────────
meta_table = doc.add_table(rows=2, cols=3)
meta_table.style = "Table Grid"
meta_data = [
    ("Document Type", "Clinical Case File", ""),
    ("Patient Age",   "35 Years",           "Date: " + datetime.date.today().strftime("%d %B %Y")),
]
for r_idx, row_data in enumerate(meta_data):
    row = meta_table.rows[r_idx]
    for c_idx, cell_text in enumerate(row_data):
        cell = row.cells[c_idx]
        p = cell.paragraphs[0]
        p.clear()
        if c_idx == 0:
            run = p.add_run(cell_text)
            run.bold = True
            run.font.size = Pt(9)
            run.font.color.rgb = RGBColor(10, 41, 92)
        else:
            run = p.add_run(cell_text)
            run.font.size = Pt(9)

doc.add_paragraph()  # spacer

# ══════════════════════════════════════════════════════════════════════
# SECTION HELPER
# ══════════════════════════════════════════════════════════════════════
def add_section_heading(text):
    p = doc.add_paragraph()
    p.alignment = WD_ALIGN_PARAGRAPH.LEFT
    shade_paragraph(p, "1A5EA8")
    run = p.add_run("  " + text.upper())
    run.bold = True
    run.font.size = Pt(11)
    run.font.color.rgb = RGBColor(255, 255, 255)
    run.font.name = "Calibri"
    return p

def add_body(text, bold_prefix=None):
    p = doc.add_paragraph()
    p.paragraph_format.left_indent = Inches(0.2)
    p.paragraph_format.space_after = Pt(4)
    if bold_prefix:
        r1 = p.add_run(bold_prefix + "  ")
        r1.bold = True
        r1.font.color.rgb = RGBColor(10, 41, 92)
        r1.font.size = Pt(11)
    r2 = p.add_run(text)
    r2.font.size = Pt(11)
    r2.font.name = "Calibri"
    return p

def add_highlight_box(text, bg="EEF4FF", text_color=(10, 41, 92)):
    p = doc.add_paragraph()
    p.paragraph_format.left_indent  = Inches(0.3)
    p.paragraph_format.right_indent = Inches(0.3)
    p.paragraph_format.space_before = Pt(4)
    p.paragraph_format.space_after  = Pt(4)
    shade_paragraph(p, bg)
    run = p.add_run(text)
    run.font.size = Pt(11)
    run.font.name = "Calibri"
    run.font.color.rgb = RGBColor(*text_color)
    return p

# ══════════════════════════════════════════════════════════════════════
# SECTION 1 — CASE PRESENTATION
# ══════════════════════════════════════════════════════════════════════
add_section_heading("1. Case Presentation")
doc.add_paragraph()

add_body(
    "A 35-year-old gentleman presented to us with knee stiffness 3 months after surgery "
    "done for a fracture of the proximal tibia.",
    bold_prefix="Patient History:"
)
add_body(
    "Before the procedure under anesthesia, his range of motion was 0°–95° of flexion.",
    bold_prefix="Pre-Procedure ROM:"
)

doc.add_paragraph()

# ══════════════════════════════════════════════════════════════════════
# SECTION 2 — PROCEDURE DETAILS
# ══════════════════════════════════════════════════════════════════════
add_section_heading("2. Procedure Details")
doc.add_paragraph()

add_body(
    "The therapist then began the knee manipulation procedure, gradually increasing the flexion.",
    bold_prefix="Initiation:"
)
add_body(
    "During the procedure, the knee was gently bent, avoiding jerky or forceful movements, "
    "to reduce the risk of ligament injury.",
    bold_prefix="Technique:"
)
add_body(
    "The therapist held the whole length of the tibia with both hands and forearm, "
    "gradually pushing the tibia posteriorly using his body weight.",
    bold_prefix="Grip & Force:"
)

doc.add_paragraph()

# ══════════════════════════════════════════════════════════════════════
# SECTION 3 — OUTCOME
# ══════════════════════════════════════════════════════════════════════
add_section_heading("3. Outcome")
doc.add_paragraph()

add_body(
    "After the procedure, a range of motion of approximately 125° of flexion was achieved.",
    bold_prefix="Post-Procedure ROM:"
)
add_body(
    "Smooth movement was observed immediately after manipulation under anesthesia. "
    "The knee was moving freely from 0°–125°.",
    bold_prefix="Movement Quality:"
)

doc.add_paragraph()

# ══════════════════════════════════════════════════════════════════════
# SECTION 4 — POST-PROCEDURE INSTRUCTIONS
# ══════════════════════════════════════════════════════════════════════
add_section_heading("4. Post-Procedure Instructions")
doc.add_paragraph()

add_body(
    "It is very important to start physiotherapy as soon as possible after the procedure "
    "and continue for a few weeks; otherwise, the patient will experience stiffness again.",
    bold_prefix="Physiotherapy:"
)

doc.add_paragraph()

# Important note box
add_highlight_box(
    "⚠  Note: Without consistent physiotherapy following the procedure, scar tissue adhesions "
    "will re-form and the patient will regain stiffness. Early and regular mobilization is "
    "the key to maintaining the range of motion achieved during MUA.",
    bg="FFF3E0", text_color=(180, 60, 0)
)

doc.add_paragraph()

# ══════════════════════════════════════════════════════════════════════
# SECTION 5 — CORRECTED FULL CASE NOTE (CONTINUOUS PARAGRAPH)
# ══════════════════════════════════════════════════════════════════════
add_section_heading("5. Corrected Full Case Note")
doc.add_paragraph()

full_note = doc.add_paragraph()
full_note.paragraph_format.left_indent  = Inches(0.3)
full_note.paragraph_format.right_indent = Inches(0.3)
shade_paragraph(full_note, "EEF4FF")
run = full_note.add_run(
    "A 35-year-old gentleman presented to us with knee stiffness 3 months after surgery done for a fracture "
    "of the proximal tibia. Before the procedure under anesthesia, his range of motion was 0°–95° of flexion. "
    "The therapist then began the knee manipulation procedure, gradually increasing the flexion. During the "
    "procedure, the knee was gently bent, avoiding jerky or forceful movements, to reduce the risk of ligament "
    "injury. The therapist held the whole length of the tibia with both hands and forearm, gradually pushing "
    "the tibia posteriorly using his body weight. After the procedure, a range of motion of approximately 125° "
    "of flexion was achieved. Smooth movement was observed immediately after manipulation under anesthesia. "
    "The knee was moving freely from 0°–125°. It is very important to start physiotherapy as soon as possible "
    "after the procedure and continue for a few weeks; otherwise, the patient will experience stiffness again."
)
run.font.size = Pt(11)
run.font.name = "Calibri"
run.font.color.rgb = RGBColor(10, 41, 92)

doc.add_paragraph()

# ══════════════════════════════════════════════════════════════════════
# SECTION 6 — GRAMMAR CORRECTIONS SUMMARY TABLE
# ══════════════════════════════════════════════════════════════════════
add_section_heading("6. Grammar & Language Corrections Summary")
doc.add_paragraph()

corrections = [
    ("Title", "Knee manipulation under anesthesia",
     "Knee Manipulation Under Anesthesia",
     "Title Case capitalization required"),
    ("Definition", "procedure done to increase the range of motion stiff knee joint",
     "A procedure done to increase the range of motion of a stiff knee joint.",
     "Missing article 'A'; missing 'of'; missing full stop"),
    ("Case description", "35 yr old gentleman... after 3 month from surgery... proximal tibia",
     "A 35-year-old gentleman... 3 months after surgery... the proximal tibia",
     "Missing 'A'; 'yr old' → 'year-old'; '3 month' → '3 months'; missing 'the'"),
    ("Pre-procedure ROM", "under the anesthesia... is 0-95° flexion",
     "under anesthesia... was 0°–95° of flexion",
     "Drop 'the'; past tense 'was'; degree symbol on both values"),
    ("Procedure start", "he is increase the flexion",
     "gradually increasing the flexion",
     "Wrong verb form 'is increase'; arrows removed"),
    ("Technique", "In the procedure gently bending the knee",
     "During the procedure, the knee was gently bent",
     "'In' → 'During'; missing subject added; passive voice"),
    ("Grip description", "his both hands & forearm & weight of his body",
     "both hands and forearm... his body weight",
     "'his both' → 'both'; '&' → 'and'; past tense"),
    ("Outcome", "we have reached ROM flexion of around 125°",
     "a range of motion of approximately 125° of flexion was achieved",
     "Passive voice; 'around' → 'approximately'; article added"),
    ("Movement", "we can see smooth movement right after",
     "Smooth movement was observed immediately after",
     "'we can see' → 'was observed'; 'right after' → 'immediately after'"),
    ("Closing", "Its very imp. to... & continue for few week",
     "It is very important to... and continue for a few weeks",
     "'Its imp.' → 'It is important'; '&'→'and'; 'few week'→'a few weeks'"),
]

table = doc.add_table(rows=1, cols=4)
table.style = "Table Grid"

# Header row
hdr = table.rows[0].cells
headers = ["Section", "Original", "Corrected", "Issue(s)"]
for i, h in enumerate(headers):
    p = hdr[i].paragraphs[0]
    p.clear()
    run = p.add_run(h)
    run.bold = True
    run.font.size = Pt(9)
    run.font.color.rgb = RGBColor(255, 255, 255)
    # shade header cell
    tc = hdr[i]._tc
    tcPr = tc.get_or_add_tcPr()
    shd = OxmlElement("w:shd")
    shd.set(qn("w:val"), "clear")
    shd.set(qn("w:color"), "auto")
    shd.set(qn("w:fill"), "0A295C")
    tcPr.append(shd)

for idx, (section, orig, corr, issue) in enumerate(corrections):
    row = table.add_row()
    data = [section, orig, corr, issue]
    fill = "EEF4FF" if idx % 2 == 0 else "FFFFFF"
    for c_idx, text in enumerate(data):
        cell = row.cells[c_idx]
        p = cell.paragraphs[0]
        p.clear()
        run = p.add_run(text)
        run.font.size = Pt(8.5)
        run.font.name = "Calibri"
        if c_idx == 1:
            run.font.color.rgb = RGBColor(180, 60, 0)   # original = red
            run.italic = True
        elif c_idx == 2:
            run.font.color.rgb = RGBColor(10, 122, 58)  # corrected = green
            run.bold = True
        # shade row
        tc = cell._tc
        tcPr = tc.get_or_add_tcPr()
        shd = OxmlElement("w:shd")
        shd.set(qn("w:val"), "clear")
        shd.set(qn("w:color"), "auto")
        shd.set(qn("w:fill"), fill)
        tcPr.append(shd)

# Set column widths
col_widths = [Inches(1.0), Inches(2.0), Inches(2.0), Inches(1.8)]
for row in table.rows:
    for i, cell in enumerate(row.cells):
        cell.width = col_widths[i]

doc.add_paragraph()

# ══════════════════════════════════════════════════════════════════════
# FOOTER NOTE
# ══════════════════════════════════════════════════════════════════════
footer_p = doc.add_paragraph()
set_para_border_bottom(footer_p, hex_color="1A5EA8", sz="4")

footer_p2 = doc.add_paragraph()
footer_p2.alignment = WD_ALIGN_PARAGRAPH.CENTER
r = footer_p2.add_run(
    "Source: Clinical handwritten case notes + Video demonstration (Dr. Prateek Joshi)  |  "
    "Corrected for professional clinical documentation standards"
)
r.font.size = Pt(8)
r.italic = True
r.font.color.rgb = RGBColor(100, 120, 160)

# ── Save ──────────────────────────────────────────────────────────────
out = "/tmp/workspace/knee-mua-presentation/Knee_MUA_Case_File_Corrected.docx"
doc.save(out)
print("Saved:", out)