# -*- coding: utf-8 -*-
from reportlab.lib.pagesizes import A4
from reportlab.lib.units import mm
from reportlab.lib import colors
from reportlab.platypus import (SimpleDocTemplate, Paragraph, Spacer, Table, TableStyle,
                                 Image, PageBreak, HRFlowable, KeepTogether)
from reportlab.lib.styles import getSampleStyleSheet, ParagraphStyle
from reportlab.lib.enums import TA_CENTER, TA_LEFT
import os

ASSETS = "/tmp/workspace/rguhs_peds_infections/assets"
OUT = "/tmp/workspace/rguhs_peds_infections/output/RGUHS_Pediatrics_Infections_Infestations_StudySheet.pdf"

styles = getSampleStyleSheet()

title_style = ParagraphStyle('title', parent=styles['Title'], fontSize=20, textColor=colors.white,
                              alignment=TA_CENTER, spaceAfter=2)
subtitle_style = ParagraphStyle('subtitle', parent=styles['Normal'], fontSize=11, textColor=colors.whitesmoke,
                                 alignment=TA_CENTER)
disease_title_style = ParagraphStyle('dtitle', parent=styles['Title'], fontSize=22, textColor=colors.white,
                                      alignment=TA_CENTER, spaceAfter=0)
mnemonic_style = ParagraphStyle('mnemonic', parent=styles['Normal'], fontSize=10.5, textColor=colors.HexColor("#5b2c00"),
                                 leading=14)
body_style = ParagraphStyle('body', parent=styles['Normal'], fontSize=9.7, leading=13.2, textColor=colors.HexColor("#1a1a1a"))
heading_label_style = ParagraphStyle('hlabel', parent=styles['Normal'], fontSize=11, textColor=colors.white,
                                      fontName='Helvetica-Bold')

# Color themes per disease (header band, section header bg, accent)
THEMES = {
    "measles":    {"main": "#E63946", "light": "#FDE2E4", "accent": "#F1FAEE"},
    "diphtheria": {"main": "#2A6F97", "light": "#D6EFFF", "accent": "#EAF6FF"},
    "pertussis":  {"main": "#6A4C93", "light": "#EAE0F8", "accent": "#F5EFFB"},
    "tetanus":    {"main": "#B5642B", "light": "#F8E3D1", "accent": "#FDF2E9"},
    "typhoid":    {"main": "#1B8A5A", "light": "#D9F2E6", "accent": "#EAFBF2"},
}

SECTION_ORDER = ["Definition", "Types", "Etiopathogenesis", "Clinical Features",
                  "Investigations", "Treatment", "Prevention", "Complications"]

DISEASES = [
  {
    "key": "measles", "name": "MEASLES (Rubeola)", "image": "measles.png",
    "mnemonic": "Mnemonic - \"3 C's + K then Rash\": <b>C</b>ough, <b>C</b>oryza, <b>C</b>onjunctivitis, <b>K</b>oplik spots &rarr; then cephalocaudal <b>Rash</b>.",
    "content": {
      "Definition": "Acute, highly contagious viral exanthematous illness caused by Measles virus (Paramyxoviridae, genus Morbillivirus), marked by fever, catarrhal symptoms and a characteristic maculopapular rash.",
      "Types": "Typical measles; Modified measles (partial immunity/post-Ig, milder, longer incubation); Atypical measles (in old killed-vaccine recipients, peripheral rash, pneumonia); Hemorrhagic/malignant \"black measles\" (severe, bleeding into skin).",
      "Etiopathogenesis": "ssRNA Morbillivirus spread by droplets &rarr; infects respiratory epithelium &rarr; local replication &rarr; primary viremia to RE system &rarr; secondary viremia seeds skin, conjunctiva, respiratory tract &rarr; rash reflects cell-mediated immune (T-cell) response to virus in skin capillaries &rarr; transient immunosuppression predisposes to secondary bacterial infection.",
      "Clinical Features": "Incubation 8-12 days. <b>Prodromal/catarrhal stage</b> (3-4 days): fever, cough, coryza, conjunctivitis (3 C's), Koplik spots (pathognomonic - bluish-white specks on buccal mucosa opposite molars). <b>Rash stage</b>: erythematous maculopapular rash starts on face/behind ears &rarr; spreads cephalocaudally over 3 days, fades with brownish staining/desquamation in same order.",
      "Investigations": "Usually clinical. Measles-specific IgM ELISA (confirmatory); 4-fold rise in IgG; multinucleated giant cells (Warthin-Finkeldey) in smears; leukopenia with relative lymphocytosis.",
      "Treatment": "Supportive - antipyretics, adequate hydration/nutrition. <b>Vitamin A</b> supplementation (2 doses, age-based) reduces morbidity/mortality and ocular complications. Antibiotics only for secondary bacterial infection (otitis media, pneumonia). No specific antiviral.",
      "Prevention": "MMR/Measles vaccine at 9-12 months, 2nd dose at 16-24 months (per national schedule); herd immunity via high coverage; Vitamin A prophylaxis; isolate case till 4 days after rash onset; post-exposure vaccine within 72 hrs or immunoglobulin for high-risk contacts.",
      "Complications": "Otitis media (most common); Pneumonia (most common cause of death); Laryngotracheobronchitis (croup); Diarrhea/malnutrition; Acute encephalitis (1 in 1000); Subacute Sclerosing Panencephalitis - SSPE (fatal, years later); Keratomalacia/blindness (with Vit A deficiency); Reactivation of TB."
    }
  },
  {
    "key": "diphtheria", "name": "DIPHTHERIA", "image": "diphtheria.png",
    "mnemonic": "Mnemonic - \"MAD PENS\": <b>M</b>yocarditis, <b>A</b>irway obstruction, <b>D</b>emyelinating neuropathy/palatal palsy are the toxin's targets - treat urgently with <b>P</b>enicillin/erythromycin + <b>E</b>quine a<b>N</b>titoxin + <b>S</b>trict isolation.",
    "content": {
      "Definition": "Acute contagious bacterial infection caused by toxigenic <i>Corynebacterium diphtheriae</i>, producing a grayish adherent pseudomembrane over mucosa (usually pharynx/tonsils) with systemic toxin effects on heart and nerves.",
      "Types": "Classified by site: Faucial/tonsillo-pharyngeal (most common), Laryngeal, Nasal, Cutaneous, Conjunctival, Otic. By severity: Malignant/hypertoxic \"bull-neck\" diphtheria (severe, high mortality).",
      "Etiopathogenesis": "Gram-positive, club-shaped, pleomorphic bacillus; toxigenic strains carry a lysogenic beta-phage encoding the <i>tox</i> gene &rarr; exotoxin inhibits protein synthesis by ADP-ribosylating elongation factor-2 &rarr; local epithelial necrosis + fibrin exudate forms the pseudomembrane &rarr; toxin absorbed systemically &rarr; binds heart (myocarditis) and peripheral/cranial nerves (demyelination).",
      "Clinical Features": "Gradual onset - low-grade fever, sore throat, malaise out of proportion to exam. Grayish-white adherent membrane over tonsils/pharynx that bleeds on attempted removal; foul breath; \"bull neck\" from cervical lymphadenopathy + soft tissue edema; hoarseness, stridor, brassy cough if laryngeal spread (risk of airway obstruction).",
      "Investigations": "Throat swab (below membrane edge) for culture on Loeffler's serum slope / tellurite media; Gram/Albert staining; <b>Elek's gel-precipitation test</b> for toxigenicity; ECG and cardiac enzymes to monitor myocarditis; clinical diagnosis is priority - treat before culture confirmation.",
      "Treatment": "<b>Diphtheria antitoxin</b> (equine) after test dose - given immediately on clinical suspicion, dose depends on site/severity/duration; Antibiotics - Penicillin G or Erythromycin (eliminates carriage, halts toxin production); strict bed rest (avoid exertion - sudden cardiac death risk); secure airway/tracheostomy if obstruction; manage myocarditis and neuropathy supportively.",
      "Prevention": "DPT primary series (6, 10, 14 weeks) with boosters at 16-24 months and 5 years (national schedule); Td booster later; case isolation till 2 negative cultures; chemoprophylaxis (erythromycin) + toxoid for close contacts; maintain herd immunity.",
      "Complications": "<b>Myocarditis</b> (leading cause of death, arrhythmias/CHF); Palatal palsy (nasal regurgitation, nasal voice); Polyneuritis (usually 2-6 weeks after onset - can cause diaphragmatic paralysis); Airway obstruction/asphyxia; Toxic nephritis; Bronchopneumonia."
    }
  },
  {
    "key": "pertussis", "name": "PERTUSSIS (Whooping Cough)", "image": "pertussis.png",
    "mnemonic": "Mnemonic - \"CPC-Whoop\": <b>C</b>atarrhal &rarr; <b>P</b>aroxysmal &rarr; <b>C</b>onvalescent stages; remember paroxysms end in inspiratory <b>Whoop</b> + post-tussive vomiting; give macrolide early!",
    "content": {
      "Definition": "Acute, highly contagious respiratory tract infection caused by <i>Bordetella pertussis</i>, characterized by paroxysms of severe coughing ending in an inspiratory \"whoop\".",
      "Types": "Classic pertussis (B. pertussis); pertussis-like illness from B. parapertussis (milder); atypical/attenuated disease in partially immunized children, adolescents and adults (persistent cough without classic whoop).",
      "Etiopathogenesis": "Gram-negative coccobacillus attaches to ciliated respiratory epithelium via filamentous hemagglutinin and pertactin &rarr; releases pertussis toxin and tracheal cytotoxin &rarr; ciliary paralysis and local mucosal damage impair clearance of secretions &rarr; systemic toxin effects cause marked lymphocytosis and hypoglycemia; no bacteremia.",
      "Clinical Features": "Three overlapping stages over ~6-8 weeks: <b>Catarrhal</b> (1-2 wks) - coryza, mild cough, low fever, most contagious/best time to culture; <b>Paroxysmal</b> (2-4 wks) - repeated forceful coughs ending in inspiratory whoop, post-tussive vomiting, worse at night, child appears well between spells; young infants may present with apnea/cyanosis instead of whoop; <b>Convalescent</b> (weeks-months) - gradually decreasing cough.",
      "Investigations": "Nasopharyngeal swab culture on Bordet-Gengou medium (gold standard but low yield after catarrhal stage); PCR (most sensitive, preferred now); marked absolute lymphocytosis on CBC; chest X-ray if pneumonia suspected.",
      "Treatment": "Macrolides - Azithromycin (preferred) or Erythromycin, most effective if started in catarrhal stage (reduces infectivity, may not shorten paroxysmal symptoms once established); supportive care - small frequent feeds, oxygen, monitor young infants closely for apnea/hypoxia; avoid sedatives/cough suppressants; hospitalize infants <6 months.",
      "Prevention": "DTaP/DPT vaccination as part of primary series (6, 10, 14 weeks) plus boosters; Tdap in pregnancy (passive protection to neonate); chemoprophylaxis (azithromycin) for close household/high-risk contacts; isolate case for 5 days after starting antibiotics (or 3 weeks from cough onset if untreated).",
      "Complications": "<b>Pneumonia</b> (most common cause of death, often secondary bacterial); seizures and pertussis encephalopathy; apnea/hypoxia in infants; subconjunctival/scleral hemorrhage from severe coughing; umbilical/inguinal hernia, rectal prolapse; malnutrition from vomiting; otitis media."
    }
  },
  {
    "key": "tetanus", "name": "TETANUS", "image": "tetanus.png",
    "mnemonic": "Mnemonic - \"TRISM\": <b>T</b>rismus (earliest sign), <b>R</b>isus sardonicus, <b>I</b>ncreased tone/rigidity, <b>S</b>pasms (stimulus-triggered), <b>M</b>etronidazole + HTIG is the mainstay of treatment.",
    "content": {
      "Definition": "Acute, often fatal disease caused by the neurotoxin <b>tetanospasmin</b> of <i>Clostridium tetani</i>, characterized by muscular rigidity and painful spasms, with sensorium preserved.",
      "Types": "<b>Generalized tetanus</b> (most common - descending pattern starting with trismus); <b>Neonatal tetanus</b> (entry via unhygienic umbilical stump care, high mortality); <b>Localized tetanus</b> (rigidity confined to muscles near wound); <b>Cephalic tetanus</b> (following head/face wounds, cranial nerve palsies).",
      "Etiopathogenesis": "<i>C. tetani</i> - gram-positive, anaerobic, spore-forming, \"drumstick\"-shaped bacillus; spores contaminate deep/dirty wounds &rarr; germinate in anaerobic/necrotic tissue &rarr; produce tetanospasmin &rarr; toxin taken up at neuromuscular junction, transported retrograde via peripheral nerve axons to spinal cord/brainstem &rarr; blocks release of inhibitory neurotransmitters GABA and glycine at inhibitory interneurons &rarr; loss of inhibition causes sustained muscle contraction (rigidity) and reflex spasms; autonomic nuclei involvement causes sympathetic overactivity in severe disease.",
      "Clinical Features": "Incubation 3-21 days (shorter incubation/period of onset = worse prognosis). <b>Trismus</b> (lockjaw) - usually earliest sign; <b>Risus sardonicus</b> (sardonic grin from facial muscle spasm); neck/back rigidity progressing to <b>opisthotonus</b> (arched back); generalized rigidity with intermittent painful spasms triggered by minimal stimuli (light, sound, touch); autonomic instability (labile BP/HR, sweating) in severe cases; consciousness and sensorium remain <b>fully preserved</b> throughout.",
      "Investigations": "Purely a <b>clinical diagnosis</b> - no confirmatory lab test; wound culture for <i>C. tetani</i> is insensitive and not required to start treatment; \"spatula test\" - touching oropharynx provokes reflex bite instead of gag (highly suggestive); CPK may be raised from sustained muscle contraction.",
      "Treatment": "<b>Human Tetanus Immunoglobulin (HTIG)</b> to neutralize circulating unbound toxin (does not affect toxin already bound in CNS); thorough wound debridement to remove anaerobic focus; <b>Metronidazole</b> (drug of choice) or Penicillin G to kill vegetative bacteria; control spasms/rigidity with benzodiazepines (diazepam) +/- muscle relaxants; manage airway - may need sedation, ventilation in severe generalized disease; nurse in a quiet, dark, low-stimulus room; manage autonomic dysfunction (e.g., magnesium sulfate, labetalol) in severe cases.",
      "Prevention": "Complete primary DPT/Td immunization with age-appropriate boosters; proper wound care with tetanus toxoid +/- TIG based on wound category and immunization status; maternal TT immunization and clean/aseptic delivery and cord care to prevent neonatal tetanus (a key MCH program goal)."
    }
  },
  {
    "key": "typhoid", "name": "ENTERIC (TYPHOID) FEVER", "image": "typhoid.png",
    "mnemonic": "Mnemonic - \"STEP-R\": <b>S</b>tepladder fever, relative bra<b>Dycardia</b>, <b>R</b>ose spots, hepato<b>S</b>plenomegaly, <b>P</b>erforation/bleeding (feared 3rd-4th week), altered sensorium (typhoid state).",
    "content": {
      "Definition": "Systemic febrile illness caused by <i>Salmonella enterica</i> serotype Typhi (or Paratyphi), acquired via the fecal-oral route, characterized by prolonged fever and involvement of the reticuloendothelial system and Peyer's patches of the terminal ileum.",
      "Types": "<b>Typhoid fever</b> (S. Typhi - classically more severe); <b>Paratyphoid fever</b> (S. Paratyphi A/B/C - generally milder, shorter course); <b>Chronic carrier state</b> (organism persists in gallbladder, especially with gallstones, for >1 year, source of transmission).",
      "Etiopathogenesis": "Ingested gram-negative bacilli survive gastric acid &rarr; invade M cells over Peyer's patches in terminal ileum &rarr; taken up by macrophages and survive/multiply intracellularly &rarr; spread to mesenteric lymph nodes &rarr; transient primary bacteremia (often asymptomatic) &rarr; seeding of liver, spleen, bone marrow, gallbladder (reticuloendothelial system) &rarr; multiplication and release causes secondary bacteremia with onset of clinical illness &rarr; reinvasion of gut leads to necrosis/ulceration of Peyer's patches, which can perforate or bleed.",
      "Clinical Features": "Stepladder pattern of rising fever over the first week; headache, malaise, anorexia; abdominal pain/discomfort; constipation more common in children (vs diarrhea in adults); relative bradycardia (pulse-temperature dissociation); coated tongue, hepatosplenomegaly; <b>rose spots</b> - faint pink blanching macules on trunk (seen in ~30%); in severe/late disease - \"typhoid state\" with apathy, delirium, muteness.",
      "Investigations": "<b>Blood culture</b> - most useful in first week (gold standard for early diagnosis); <b>bone marrow culture</b> - most sensitive overall, positive even after antibiotics started; stool and urine culture become positive later (2nd-3rd week); <b>Widal test</b> - rising/high O and H antibody titers, limited by cross-reactivity and prior vaccination (interpret with caution); CBC often shows leukopenia with relative lymphocytosis; deranged LFTs common.",
      "Treatment": "Empirical antibiotics given rising resistance - <b>Ceftriaxone/Cefixime</b> (third-generation cephalosporins) are first-line in most regions; <b>Azithromycin</b> for uncomplicated disease; fluoroquinolones only if strain confirmed sensitive; supportive care - hydration, antipyretics, nutritious soft diet; surgical management for intestinal perforation.",
      "Prevention": "Typhoid conjugate vaccine (TCV), included in several national immunization programs; safe drinking water, sanitation and sewage disposal; food hygiene and hand washing; identification and treatment/exclusion of chronic carriers (especially food handlers) from food-handling duties.",
      "Complications": "<b>Intestinal perforation and hemorrhage</b> (most feared, typically 3rd-4th week); typhoid encephalopathy; myocarditis; cholecystitis and chronic carriage; relapse (10%, usually milder); osteomyelitis (especially with sickle cell disease)."
    }
  },
]

def build():
    doc = SimpleDocTemplate(OUT, pagesize=A4,
                             topMargin=10*mm, bottomMargin=10*mm,
                             leftMargin=12*mm, rightMargin=12*mm)
    flow = []

    # Cover
    cover_style = ParagraphStyle('cover', parent=styles['Title'], fontSize=26, alignment=TA_CENTER,
                                  textColor=colors.HexColor("#1B1B3A"))
    cover_sub = ParagraphStyle('coversub', parent=styles['Normal'], fontSize=13, alignment=TA_CENTER,
                                textColor=colors.HexColor("#444444"), spaceBefore=6)
    flow.append(Spacer(1, 60*mm))
    flow.append(Paragraph("RGUHS Pediatrics", cover_style))
    flow.append(Paragraph("INFECTIONS AND INFESTATIONS", ParagraphStyle('cov2', parent=cover_style, fontSize=20,
                                                                          textColor=colors.HexColor("#E63946"))))
    flow.append(Spacer(1, 6*mm))
    flow.append(Paragraph("Illustrated High-Yield Answer Sheet with Mnemonics", cover_sub))
    flow.append(Paragraph("Ref: OP Ghai - Essential Pediatrics (standard content)", cover_sub))
    flow.append(Spacer(1, 10*mm))
    flow.append(Paragraph("Measles &bull; Diphtheria &bull; Pertussis &bull; Tetanus &bull; Enteric Fever", cover_sub))
    flow.append(PageBreak())

    for d in DISEASES:
        theme = THEMES[d["key"]]
        main = colors.HexColor(theme["main"])
        light = colors.HexColor(theme["light"])
        accent = colors.HexColor(theme["accent"])

        # Header band with disease name
        header_tbl = Table([[Paragraph(d["name"], disease_title_style)]], colWidths=[171*mm])
        header_tbl.setStyle(TableStyle([
            ('BACKGROUND', (0,0), (-1,-1), main),
            ('TOPPADDING', (0,0), (-1,-1), 8),
            ('BOTTOMPADDING', (0,0), (-1,-1), 8),
            ('VALIGN', (0,0), (-1,-1), 'MIDDLE'),
        ]))
        flow.append(header_tbl)
        flow.append(Spacer(1, 3*mm))

        # Image
        img_path = os.path.join(ASSETS, d["image"])
        img = Image(img_path, width=100*mm, height=100*mm)
        img.hAlign = 'CENTER'
        flow.append(img)
        flow.append(Spacer(1, 3*mm))

        # Mnemonic box
        mnem_tbl = Table([[Paragraph(d["mnemonic"], mnemonic_style)]], colWidths=[171*mm])
        mnem_tbl.setStyle(TableStyle([
            ('BACKGROUND', (0,0), (-1,-1), colors.HexColor("#FFF3B0")),
            ('BOX', (0,0), (-1,-1), 1.2, colors.HexColor("#D4A017")),
            ('TOPPADDING', (0,0), (-1,-1), 6),
            ('BOTTOMPADDING', (0,0), (-1,-1), 6),
            ('LEFTPADDING', (0,0), (-1,-1), 8),
            ('RIGHTPADDING', (0,0), (-1,-1), 8),
        ]))
        flow.append(mnem_tbl)
        flow.append(Spacer(1, 4*mm))
        flow.append(PageBreak())

        # Section pages - group 2 sections per "card" area, keep together
        for sec in SECTION_ORDER:
            text = d["content"][sec]
            label_tbl = Table([[Paragraph(sec.upper(), heading_label_style)]], colWidths=[171*mm])
            label_tbl.setStyle(TableStyle([
                ('BACKGROUND', (0,0), (-1,-1), main),
                ('TOPPADDING', (0,0), (-1,-1), 5),
                ('BOTTOMPADDING', (0,0), (-1,-1), 5),
                ('LEFTPADDING', (0,0), (-1,-1), 8),
            ]))
            body_tbl = Table([[Paragraph(text, body_style)]], colWidths=[171*mm])
            body_tbl.setStyle(TableStyle([
                ('BACKGROUND', (0,0), (-1,-1), light if sec in ("Definition","Etiopathogenesis","Treatment","Complications") else accent),
                ('TOPPADDING', (0,0), (-1,-1), 7),
                ('BOTTOMPADDING', (0,0), (-1,-1), 7),
                ('LEFTPADDING', (0,0), (-1,-1), 8),
                ('RIGHTPADDING', (0,0), (-1,-1), 8),
                ('BOX', (0,0), (-1,-1), 0.6, colors.HexColor("#CCCCCC")),
            ]))
            flow.append(KeepTogether([label_tbl, body_tbl, Spacer(1, 3*mm)]))

        flow.append(PageBreak())

    doc.build(flow)
    print("PDF built at", OUT)

if __name__ == "__main__":
    build()

Successfully replaced 1 instance(s) of the string in '/tmp/workspace/rguhs_peds_infections/build_pdf.py'