python -m markitdown "/home/daytona/workspace/attachments/d244996a-f360-4e40-988…

cd /home/daytona/workspace/attachments/d244996a-f360-4e40-9886-94579b7974cd/ && …

pip install python-pptx --quiet 2>&1 | tail -3

cd "/home/daytona/workspace/attachments/d244996a-f360-4e40-9886-94579b7974cd/" &…

cd "/home/daytona/workspace/attachments/d244996a-f360-4e40-9886-94579b7974cd/" &…

# Convert images to base64 and serve them, or check if they can be read as file…

python3 -c " from PIL import Image img = Image.open('/home/daytona/workspace/spo…

pip install Pillow --quiet 2>&1 | tail -2 && python3 -c " from PIL import Image …

python3 -c " from PIL import Image img = Image.open('/home/daytona/workspace/spo…

~/spotting_study_guide/generate_pdf.py

from reportlab.lib.pagesizes import A4
from reportlab.lib.styles import getSampleStyleSheet, ParagraphStyle
from reportlab.lib.units import cm, mm
from reportlab.lib import colors
from reportlab.platypus import (
    SimpleDocTemplate, Paragraph, Spacer, Table, TableStyle,
    HRFlowable, KeepTogether, PageBreak
)
from reportlab.platypus.flowables import HRFlowable
from reportlab.lib.enums import TA_LEFT, TA_CENTER, TA_JUSTIFY
from reportlab.pdfbase import pdfmetrics


# ─── colour palette ───────────────────────────────────────────────────────────
DARK_BLUE   = colors.HexColor("#1A237E")   # title / spot headers
MID_BLUE    = colors.HexColor("#1565C0")   # question number bands
ACCENT_TEAL = colors.HexColor("#00838F")   # sub-headings
LIGHT_BG    = colors.HexColor("#E8EAF6")   # spot header background
VERY_LIGHT  = colors.HexColor("#F5F5F5")   # table row alt
ANSWER_BG   = colors.HexColor("#E3F2FD")   # answer area background tint
ORANGE      = colors.HexColor("#E65100")   # key-points / mnemonics
GREEN       = colors.HexColor("#1B5E20")   # important facts
WHITE       = colors.white
BLACK       = colors.HexColor("#212121")


# ─── page setup ───────────────────────────────────────────────────────────────
OUTPUT_PATH = "/home/daytona/workspace/spotting_study_guide/Community_Medicine_Spotting_Study_Guide.pdf"

doc = SimpleDocTemplate(
    OUTPUT_PATH,
    pagesize=A4,
    leftMargin=1.8*cm,
    rightMargin=1.8*cm,
    topMargin=2.0*cm,
    bottomMargin=2.0*cm,
    title="Community Medicine Spotting - Study Guide",
    author="Orris AI",
)

PAGE_W = A4[0] - 3.6*cm   # usable width


# ─── styles ───────────────────────────────────────────────────────────────────
base = getSampleStyleSheet()

def S(name, **kw):
    """Quick ParagraphStyle factory."""
    return ParagraphStyle(name, **kw)

COVER_TITLE = S("CoverTitle", fontName="Helvetica-Bold", fontSize=28,
                textColor=WHITE, alignment=TA_CENTER, spaceAfter=6)
COVER_SUB   = S("CoverSub",   fontName="Helvetica",      fontSize=14,
                textColor=colors.HexColor("#BBDEFB"), alignment=TA_CENTER, spaceAfter=4)
COVER_INFO  = S("CoverInfo",  fontName="Helvetica",      fontSize=11,
                textColor=colors.HexColor("#E3F2FD"), alignment=TA_CENTER, spaceAfter=3)

SPOT_TITLE  = S("SpotTitle",  fontName="Helvetica-Bold", fontSize=15,
                textColor=WHITE, alignment=TA_LEFT, leftIndent=6, spaceAfter=2)
SPECIMEN    = S("Specimen",   fontName="Helvetica-BoldOblique", fontSize=11,
                textColor=DARK_BLUE, spaceAfter=4, spaceBefore=2)
Q_LABEL     = S("QLabel",     fontName="Helvetica-Bold", fontSize=10,
                textColor=WHITE, spaceBefore=0, spaceAfter=0, leftIndent=4)
ANSWER_BODY = S("AnswerBody", fontName="Helvetica",      fontSize=9.5,
                textColor=BLACK, leading=14, spaceAfter=3, leftIndent=8, rightIndent=4)
ANSWER_BOLD = S("AnswerBold", fontName="Helvetica-Bold", fontSize=9.5,
                textColor=BLACK, leading=14, spaceAfter=2, leftIndent=8)
BULLET      = S("Bullet",     fontName="Helvetica",      fontSize=9.5,
                textColor=BLACK, leading=13, spaceAfter=1, leftIndent=16,
                firstLineIndent=-8)
KEY_POINT   = S("KeyPoint",   fontName="Helvetica-Bold", fontSize=9.5,
                textColor=ORANGE, leading=13, spaceAfter=2, leftIndent=8)
IMPORTANT   = S("Important",  fontName="Helvetica-Bold", fontSize=9.5,
                textColor=GREEN, leading=13, spaceAfter=2, leftIndent=8)
SECTION_HDR = S("SectionHdr", fontName="Helvetica-Bold", fontSize=10,
                textColor=ACCENT_TEAL, spaceBefore=6, spaceAfter=2, leftIndent=8)
TOC_ITEM    = S("TocItem",    fontName="Helvetica",      fontSize=10,
                textColor=BLACK, leading=16, leftIndent=12)
TOC_TITLE   = S("TocTitle",   fontName="Helvetica-Bold", fontSize=13,
                textColor=DARK_BLUE, spaceAfter=8, alignment=TA_CENTER)
FOOTER_NOTE = S("FooterNote", fontName="Helvetica-Oblique", fontSize=8,
                textColor=colors.grey, alignment=TA_CENTER)


# ─── helpers ──────────────────────────────────────────────────────────────────
def hr(color=DARK_BLUE, thickness=0.8):
    return HRFlowable(width="100%", thickness=thickness, color=color, spaceAfter=4, spaceBefore=4)


def spot_header(number, title, specimen_text):
    """Coloured banner for each spot."""
    data = [[Paragraph(f"SPOT {number}  |  {title}", SPOT_TITLE)]]
    t = Table(data, colWidths=[PAGE_W])
    t.setStyle(TableStyle([
        ("BACKGROUND", (0,0), (-1,-1), DARK_BLUE),
        ("TOPPADDING",    (0,0), (-1,-1), 7),
        ("BOTTOMPADDING", (0,0), (-1,-1), 7),
        ("LEFTPADDING",   (0,0), (-1,-1), 10),
        ("RIGHTPADDING",  (0,0), (-1,-1), 8),
        ("ROUNDEDCORNERS", [5]),
    ]))
    elems = [t]
    if specimen_text:
        elems.append(Paragraph(f"&#9654; Specimen: <b>{specimen_text}</b>", SPECIMEN))
    return elems


def q_row(q_num, question_text, answer_lines):
    """
    Renders one Q&A block as a mini-table with coloured question band
    and white answer area.
    """
    q_para = Paragraph(f"Q{q_num}. {question_text}", Q_LABEL)
    ans_paras = []
    for line in answer_lines:
        style = ANSWER_BODY
        tag   = line[:2] if len(line) > 2 else ""
        if tag == "**":
            style = ANSWER_BOLD
            line  = line[2:].strip()
        elif tag == ">>":
            style = KEY_POINT
            line  = "&#9733; " + line[2:].strip()
        elif tag == "!!":
            style = IMPORTANT
            line  = "&#10004; " + line[2:].strip()
        elif tag == "- ":
            style = BULLET
            line  = "&#8226;  " + line[2:].strip()
        ans_paras.append(Paragraph(line, style))

    q_cell  = [q_para]
    ans_cell = ans_paras if ans_paras else [Paragraph(" ", ANSWER_BODY)]

    t = Table(
        [[q_cell], [ans_cell]],
        colWidths=[PAGE_W],
    )
    t.setStyle(TableStyle([
        # question row
        ("BACKGROUND",    (0,0), (-1,0), MID_BLUE),
        ("TOPPADDING",    (0,0), (-1,0), 5),
        ("BOTTOMPADDING", (0,0), (-1,0), 5),
        ("LEFTPADDING",   (0,0), (-1,0), 8),
        # answer row
        ("BACKGROUND",    (0,1), (-1,1), ANSWER_BG),
        ("TOPPADDING",    (0,1), (-1,1), 5),
        ("BOTTOMPADDING", (0,1), (-1,1), 6),
        ("LEFTPADDING",   (0,1), (-1,1), 4),
        ("RIGHTPADDING",  (0,1), (-1,-1), 6),
        ("BOX",           (0,0), (-1,-1), 0.5, colors.HexColor("#90CAF9")),
        ("LINEBELOW",     (0,0), (-1,0), 0.3, WHITE),
    ]))
    return [t, Spacer(1, 5)]


def simple_table(headers, rows, col_widths=None):
    """Generic data table with styled header row."""
    if col_widths is None:
        col_widths = [PAGE_W / len(headers)] * len(headers)
    header_row = [Paragraph(f"<b>{h}</b>", S("TH", fontName="Helvetica-Bold",
                  fontSize=9, textColor=WHITE, alignment=TA_CENTER)) for h in headers]
    data = [header_row]
    for i, row in enumerate(rows):
        bg = VERY_LIGHT if i % 2 == 0 else WHITE
        data.append([Paragraph(str(c), S(f"TD{i}", fontName="Helvetica",
                     fontSize=9, textColor=BLACK, leading=13)) for c in row])
    t = Table(data, colWidths=col_widths)
    t.setStyle(TableStyle([
        ("BACKGROUND",    (0,0), (-1,0), ACCENT_TEAL),
        ("ROWBACKGROUNDS",(0,1), (-1,-1), [VERY_LIGHT, WHITE]),
        ("GRID",          (0,0), (-1,-1), 0.4, colors.HexColor("#B0BEC5")),
        ("TOPPADDING",    (0,0), (-1,-1), 4),
        ("BOTTOMPADDING", (0,0), (-1,-1), 4),
        ("LEFTPADDING",   (0,0), (-1,-1), 6),
        ("RIGHTPADDING",  (0,0), (-1,-1), 6),
        ("VALIGN",        (0,0), (-1,-1), "MIDDLE"),
    ]))
    return [t, Spacer(1, 6)]


# ══════════════════════════════════════════════════════════════════════════════
# CONTENT
# ══════════════════════════════════════════════════════════════════════════════
story = []

# ── COVER PAGE ─────────────────────────────────────────────────────────────────
cover_bg_data = [[Paragraph("COMMUNITY MEDICINE", COVER_TITLE)]]
cover_bg = Table(cover_bg_data, colWidths=[PAGE_W])
cover_bg.setStyle(TableStyle([
    ("BACKGROUND",    (0,0), (-1,-1), DARK_BLUE),
    ("TOPPADDING",    (0,0), (-1,-1), 22),
    ("BOTTOMPADDING", (0,0), (-1,-1), 22),
    ("LEFTPADDING",   (0,0), (-1,-1), 10),
    ("ROUNDEDCORNERS",[8]),
]))
story.append(Spacer(1, 2*cm))
story.append(cover_bg)
story.append(Spacer(1, 0.4*cm))

sub_data = [[Paragraph("SPOTTING EXAM — COMPLETE STUDY GUIDE", COVER_SUB)]]
sub_t = Table(sub_data, colWidths=[PAGE_W])
sub_t.setStyle(TableStyle([
    ("BACKGROUND", (0,0), (-1,-1), MID_BLUE),
    ("TOPPADDING", (0,0), (-1,-1), 10),
    ("BOTTOMPADDING", (0,0), (-1,-1), 10),
    ("ROUNDEDCORNERS",[6]),
]))
story.append(sub_t)
story.append(Spacer(1, 0.6*cm))

info_lines = [
    "10 Spots  |  50 Marks  |  30 Minutes",
    "All spots answered with exam-ready notes",
    "Includes: Identification • Mechanisms • Doses • Mnemonics • Key Facts",
]
for line in info_lines:
    story.append(Paragraph(line, COVER_INFO))
story.append(Spacer(1, 0.4*cm))

# summary table on cover
sum_headers = ["Spot", "Specimen / Image", "Topic"]
sum_rows = [
    ["1", "OCP Pack (assumed)", "Contraception – Combined OCP"],
    ["2", "Aedes aegypti Mosquito", "Vector-borne diseases / Entomology"],
    ["3", "Horrock's Apparatus", "Water testing / Chlorination"],
    ["4", "Vaccine Carrier Box", "Cold Chain / UIP / AEFI"],
    ["5", "Yellow Biohazard Bag", "Biomedical Waste Management"],
    ["6", "No image", "RTI/STI Syndromic Management"],
    ["7", "RBSK Logo", "Rashtriya Bal Swasthya Karyakram"],
    ["8", "Abhayrab (Rabies Vaccine)", "Rabies / Animal Bite Management"],
    ["9", "No image (DEIC)", "RBSK / DEIC / 5×5 Matrix"],
    ["10", "Goitre (neck swelling)", "IDD / NIDDCP / FSSAI"],
]
story += simple_table(sum_headers, sum_rows, col_widths=[1.2*cm, 6.5*cm, 8.3*cm])

story.append(Paragraph("Generated by Orris AI  •  For Exam Revision Use Only", FOOTER_NOTE))
story.append(PageBreak())


# ══════════════════════════════════════════════════════════════════════════════
# SPOT 1 — OCP
# ══════════════════════════════════════════════════════════════════════════════
story += spot_header(1, "Combined Oral Contraceptive Pill (OCP)", "OCP pack / blister strip")
story.append(Spacer(1, 4))

story += q_row(1, "What is the mechanism of action?", [
    "**PRIMARY: Inhibits ovulation",
    "- Oestrogen + Progestin suppress GnRH → ↓ FSH and LH → no LH surge → no ovulation",
    "**SECONDARY mechanisms:",
    "- Thickens cervical mucus (↓ sperm penetration)",
    "- Endometrial atrophy (prevents implantation)",
    "- Alters tubal motility",
    ">>Mnemonic: OCP = Ovulation suppression + Cervical mucus + Proliferation block",
])

story += q_row(2, "Mention its dosage.", [
    "**Combined OCP:** 1 tablet daily for 21 days starting Day 1–5 of cycle; 7 pill-free days",
    "**28-day pack:** 21 active + 7 placebo tablets (no break needed)",
    "**Progestin-only pill (Mini-pill):** 1 tablet daily continuously, same time each day",
    "!!Key: Must be taken at the SAME TIME daily for maximum efficacy",
])

story += q_row(3, "Who is an eligible candidate?", [
    "**Eligible:** Healthy reproductive-age women seeking reversible contraception",
    "- Women with dysmenorrhoea, menorrhagia, endometriosis, PCOS (therapeutic benefit)",
    "**CONTRAINDICATED (ACHES warning signs):**",
    "- Smokers >35 years",
    "- Hypertension, thromboembolic disorders, breast cancer",
    "- Liver disease, undiagnosed vaginal bleeding, pregnancy",
    ">>ACHES = Abdominal pain, Chest pain, Headaches, Eye changes, Severe leg pain",
])

story += q_row(4, "List 1 advantage and 1 disadvantage.", [
    "**ADVANTAGE:** Highly effective (>99% perfect use); non-contraceptive benefits",
    "- Reduces acne, dysmenorrhoea, ovarian cysts, risk of ovarian/endometrial cancer",
    "**DISADVANTAGE:** Does NOT protect against STIs/HIV",
    "- User-dependent (daily compliance); risk of DVT/thromboembolism (especially oestrogen)",
])

story += q_row(5, "Instructions to use.", [
    "1. Start on Day 1 of menstrual cycle",
    "2. Take 1 pill daily at the same time for 21 days",
    "3. 7-day break, then start next pack",
    "**If 1 pill missed (<12 hrs late):** Take immediately; continue as normal",
    "**If >12 hrs or 2+ pills missed:** Take last missed pill NOW + barrier method for 7 days",
    "!!Report ACHES warning signs immediately to a doctor",
])
story.append(PageBreak())


# ══════════════════════════════════════════════════════════════════════════════
# SPOT 2 — Aedes aegypti
# ══════════════════════════════════════════════════════════════════════════════
story += spot_header(2, "Aedes aegypti Mosquito", "Close-up photograph of a mosquito feeding on human skin")
story.append(Spacer(1, 4))

story += q_row(1, "Identify the specimen.", [
    "**Aedes aegypti** — the 'Tiger Mosquito'",
    "Family: Culicidae | Small, dark-coloured | Day-biting mosquito",
    "Breeds in: Clean, stagnant water in artificial containers (pots, tyres, coolers, drums)",
])

story += q_row(2, "List 2 identifying features.", [
    "1. **Lyre-shaped silver-white markings** on the thorax (scutum) — resembles a lyre/violin",
    "2. **Black and white banded legs** — alternating black/white rings on tarsal segments",
    ">>Bonus: Holds body parallel to surface while feeding (unlike Anopheles at 45°)",
])

story += q_row(3, "List 2 diseases transmitted.", [
    "1. **Dengue Fever** (Flavivirus — 4 serotypes: DENV 1, 2, 3, 4)",
    "2. **Chikungunya** (Alphavirus)",
    "Also transmits: Yellow Fever (Flavivirus), Zika Virus (Flavivirus)",
    ">>Mnemonic: DCYZ = Dengue, Chikungunya, Yellow fever, Zika",
])

story += q_row(4, "List 4 control measures. (2 marks)", [
    "1. **Source Reduction:** Remove/drain standing water; cover water containers; remove discarded tyres",
    "2. **Larvicidal measures:** Temephos (Abate) in water; BTi (Bacillus thuringiensis israelensis); Larvivorous fish (Gambusia, Lebistes)",
    "3. **Adult mosquito control:** Indoor Residual Spraying (IRS) with malathion/pyrethrum; fogging during outbreaks",
    "4. **Personal protection:** Mosquito nets (day-time), repellents (DEET), full-sleeve clothing, window screens",
    "!!Aedes breeds in CLEAN water unlike Culex (dirty/organic water) — key exam point",
])
story.append(PageBreak())


# ══════════════════════════════════════════════════════════════════════════════
# SPOT 3 — Horrock's Apparatus
# ══════════════════════════════════════════════════════════════════════════════
story += spot_header(3, "Horrock's Apparatus (OT Test)", "Metal box with 6 cups and reagent bottles inside")
story.append(Spacer(1, 4))

story += q_row(1, "Identify the instrument and its use.", [
    "**Instrument: Horrock's Apparatus** (also called OT Test / Comparator box)",
    "**Use:** Tests RESIDUAL CHLORINE content of water to assess adequacy of chlorination",
    "- Contains 6 numbered white cups + OT (ortho-tolidine) reagent bottle",
    "- Progressive amounts of bleaching powder in each cup (Cup 1 = least, Cup 6 = most)",
])

story += q_row(2, "Mention the indicator of this test.", [
    "**Indicator: Ortho-tolidine (OT reagent)**",
    "- Pale yellow liquid that turns BLUE/YELLOW in presence of free chlorine",
    "- Colour change: Pale yellow → Deeper yellow → Greenish-blue → Blue (with increasing chlorine)",
    ">>OT = Ortho-Tolidine = the indicator that reacts with free available chlorine",
])

story += q_row(3, "Amount of bleaching powder if 3rd cup shows blue colour?", [
    "**Answer: 2.5 grams per 1000 litres (1 kilolitre) of water**",
    "- The cup that first turns blue = minimum bleaching powder required",
    "Cup reference: Cup 1 = 0.5 g | Cup 2 = 1.5 g | Cup 3 = 2.5 g | Cup 4 = 3.5 g | Cup 5 = 5 g | Cup 6 = 7.5 g",
    "!!Rule: Add amount corresponding to the FIRST cup that turns blue",
])

story += q_row(4, "Amount of residual chlorine required for water disinfection.", [
    "**0.5 mg/L (0.5 ppm)** residual chlorine after 30 minutes contact time",
    "- At point of delivery/use: minimum **0.2 mg/L**",
    "- For emergency/field use: 0.5 ppm after 1 hour contact time",
    "- Initial dose of chlorine added: typically 2–3 ppm",
    ">>Formula: Chlorine demand + Residual chlorine = Total chlorine applied",
])

story += q_row(5, "Two other methods of water purification.", [
    "1. **Boiling** — most reliable household method; kills ALL pathogens including cysts",
    "   - Boil for 1 minute (5 minutes at high altitude >2000m)",
    "2. **Sand Filtration** — Slow Sand Filter (SSF): uses Schmutzdecke (biological layer) to remove 99% bacteria",
    "   - Rapid Sand Filter (RSF): used after coagulation-flocculation at large municipal scale",
    "Other acceptable: UV irradiation, Iodine tablets, Solar disinfection (SODIS), Reverse Osmosis",
])
story.append(PageBreak())


# ══════════════════════════════════════════════════════════════════════════════
# SPOT 4 — Vaccine Carrier
# ══════════════════════════════════════════════════════════════════════════════
story += spot_header(4, "Vaccine Carrier Box", "Blue insulated cold box with 'STOP! DO YOU NEED TO OPEN IT?' label")
story.append(Spacer(1, 4))

story += q_row(1, "Identify the specimen.", [
    "**Vaccine Carrier Box** (Cold box used in immunization programmes)",
    "- Insulated box maintaining 2–8°C for vaccine transport",
    "- Part of the COLD CHAIN system under Universal Immunisation Programme (UIP)",
    "- 'STOP' sticker: reminds health worker to open only when necessary (prevent temp loss)",
])

story += q_row(2, "How many ice packs needed and what is conditioning of ice pack?", [
    "**Number of ice packs: 4 ice packs** required in a standard vaccine carrier",
    "**Conditioning of ice packs:**",
    "- Remove frozen ice packs from freezer",
    "- Allow to stand at room temperature until water droplets (condensation) appear on surface",
    "- This ensures temp stays ABOVE 0°C inside carrier → prevents freezing of freeze-sensitive vaccines",
    "- Shake the ice pack — if you hear sloshing/movement of liquid, it is conditioned",
    "- Conditioning time: ~10–15 minutes at room temperature",
    "!!Freeze-sensitive vaccines: DPT, TT, Hepatitis B, Hib, IPV — MUST NOT freeze",
])

story += q_row(3, "What is Reverse Cold Chain?", [
    "**Definition:** System of safely transporting biological specimens FROM the field/periphery BACK to the laboratory or higher facility",
    "- Direction: Periphery → Centre (reverse of normal vaccine cold chain)",
    "**Examples:**",
    "- Blood samples for HIV testing",
    "- Stool samples for AFP (polio) surveillance",
    "- Blood samples for malaria smear/CBC from remote areas",
    "- Unused vaccines returned to higher level store",
])

story += q_row(4, "Differentiate 'Complete Immunization' and 'Full Immunization'.", [])
story += simple_table(
    ["Feature", "Complete Immunization", "Full Immunization"],
    [
        ["Definition", "All vaccines due by 2 years of age per national schedule", "BCG + 3 DPT + 3 OPV + Measles by 12 months"],
        ["Age", "By 2 years", "By 1 year (12 months)"],
        ["Context", "Newer programme definition (broader)", "Used in NFHS/WHO surveys"],
        ["Vaccines", "All UIP schedule vaccines", "6 basic antigens only"],
    ],
    col_widths=[3.5*cm, 6.0*cm, 6.5*cm]
)

story += q_row(5, "What is AEFI?", [
    "**AEFI = Adverse Event Following Immunization**",
    "**Definition:** Any untoward medical occurrence that follows immunization, not necessarily causally related to the vaccine",
    "**5 Categories:**",
    "- Vaccine-induced reaction | Vaccine-potentiated reaction",
    "- Programmatic error | Injection reaction | Coincidental event",
    "**Reporting:** All serious AEFIs → report to Medical Officer within 24 hours",
    ">>Serious AEFI = hospitalisation, disability, death, or life-threatening event",
])
story.append(PageBreak())


# ══════════════════════════════════════════════════════════════════════════════
# SPOT 5 — Yellow Biohazard Bag
# ══════════════════════════════════════════════════════════════════════════════
story += spot_header(5, "Yellow Biohazard Bag", "Yellow plastic bag labelled 'BIOHAZARD INFECTIOUS WASTE'")
story.append(Spacer(1, 4))

story += q_row(1, "Enumerate the type of waste collected in this specimen.", [
    "**YELLOW BAG** — as per BMW Management Rules 2016 (India):",
    "- Human anatomical waste (body parts, organs, foetal tissue)",
    "- Animal anatomical waste",
    "- Soiled waste (blood/body fluid-soaked dressings, bandages, linen, plaster casts)",
    "- Expired/discarded medicines (non-cytotoxic)",
    "- Chemical/pharmaceutical waste",
    "- Microbiology & biotechnology waste (except sharps)",
    "- Outdated/unused blood bags, IV fluid bags",
    ">>Colour Code: Yellow = Incineration | Red = Autoclaving | White = Sharps | Blue = Glass",
])

story += q_row(2, "Method of disposal for this bag.", [
    "**Incineration** in a dedicated incinerator at Common Biomedical Waste Treatment Facility (CBWTF)",
    "- Temperature: ≥800°C (primary chamber), ≥1050°C (secondary chamber)",
    "- Alternative: Deep burial for anatomical waste in areas without CBWTF",
    "!!Yellow bag must NEVER go to municipal solid waste or open dumping",
])

story += q_row(3, "Steps of biomedical waste management. (2 marks)", [
    "1. **Segregation at source** — separate waste into correct colour-coded bags/containers at point of generation",
    "2. **Collection** — collect in appropriate bags; fill max ¾ full; seal and label",
    "3. **Labelling** — type of waste, date, source facility on every bag/container",
    "4. **Internal transport** — dedicated trolleys; separate routes/timings; avoid passenger lifts",
    "5. **Temporary storage** — designated areas; max 48 hours; category-wise",
    "6. **Treatment & disposal** — as per category:",
    "   Yellow → Incineration | Red → Autoclave+Shredder | White → Autoclave/Encapsulation | Blue → Autoclave+Shredder",
    ">>Steps Mnemonic: S-C-L-T-S-T (Segregate, Collect, Label, Transport, Store, Treat)",
])

story += q_row(4, "Two PPE for BMW handlers.", [
    "1. **Heavy-duty rubber/nitrile gloves** (thick, puncture-resistant — NOT surgical gloves)",
    "2. **Gumboots (waterproof boots)** — protect from spills and sharps on floor",
    "Also acceptable: Impermeable apron, Face mask (N95/surgical), Safety goggles/face shield",
    "!!Full PPE = Gloves + Gumboots + Apron + Mask + Goggles for high-risk waste handling",
])
story.append(PageBreak())


# ══════════════════════════════════════════════════════════════════════════════
# SPOT 6 — RTI/STI Management
# ══════════════════════════════════════════════════════════════════════════════
story += spot_header(6, "RTI/STI Management", "No image — conceptual spot")
story.append(Spacer(1, 4))

story += q_row(1, "What is the syndromic approach in RTI/STI management?", [
    "**Definition:** Clinical management approach where a patient presenting with a SYNDROME (cluster of symptoms/signs) is treated for the MOST COMMON causative organisms — WITHOUT waiting for lab confirmation",
    "- Based on pre-defined clinical algorithms/flowcharts",
    "- Example: Vaginal discharge → treat for both Gonorrhoea AND Chlamydia simultaneously",
    "**Advantages:** Immediate treatment; no lab needed; reduces onward transmission; practical in resource-limited settings",
    "**Disadvantages:** Over-treatment; does not identify specific pathogen; risk of AMR",
])

story += q_row(2, "How many coloured kits are there in RTI/STI kits?", [
    "**6 colour-coded kits** (Kit 1–6) under India's RTI/STI management programme:",
])

story += simple_table(
    ["Kit No.", "Colour", "Syndrome"],
    [
        ["Kit 1", "Yellow", "Vaginal discharge (female)"],
        ["Kit 2", "Green", "Urethral discharge (male)"],
        ["Kit 3", "Blue", "Genital ulcer disease"],
        ["Kit 4", "White", "Lower abdominal pain / PID (female)"],
        ["Kit 5", "Red", "Inguinal bubo"],
        ["Kit 6", "Black", "Scrotal swelling / Epididymo-orchitis"],
    ],
    col_widths=[2.5*cm, 3.0*cm, 10.5*cm]
)

story += q_row(3, "Universal precaution while examining HIV patient.", [
    "**Standard (Universal) Precautions** — applied to ALL patients regardless of HIV status:",
    "- **Hand hygiene** before and after every patient contact",
    "- **Gloves** when touching blood, body fluids, mucous membranes, non-intact skin",
    "- **Mask + goggles/face shield** when splashing of blood/body fluids is possible",
    "- **Gown/apron** when clothing may be contaminated",
    "- **Safe sharps handling:** NEVER recap needles; use puncture-proof sharps containers",
    "- Dispose all contaminated material in appropriate BMW bags",
    "- **PEP** (Post-Exposure Prophylaxis) if accidental exposure occurs (start within 72 hours)",
    "!!Universal precautions treat ALL patients as potentially infectious",
])

story += q_row(4, "HIV-positive patient refuses to disclose to wife — will you tell her? Give reasons.", [
    "**YES — The wife should be informed after following due protocol.**",
    "**Step-by-step approach:**",
    "1. Counsel the patient strongly and repeatedly to disclose himself (Partner Notification Counselling)",
    "2. If patient refuses after repeated counselling, proceed with provider-initiated notification",
    "**Ethical justification:**",
    "- **Duty to warn/protect** — identifiable third party (wife) at imminent, serious, preventable risk",
    "- **Non-maleficence** — harm to the uninformed wife outweighs confidentiality",
    "- **NACP guidelines** and Indian Medical Council Regulations support partner notification",
    "- Document ALL counselling sessions thoroughly",
    ">>This is the Tarasoff principle applied to public health — duty to protect overrides confidentiality",
])
story.append(PageBreak())


# ══════════════════════════════════════════════════════════════════════════════
# SPOT 7 — RBSK
# ══════════════════════════════════════════════════════════════════════════════
story += spot_header(7, "RBSK Programme", "RBSK logo (Rashtriya Bal Swasthya Karyakram)")
story.append(Spacer(1, 4))

story += q_row(1, "Identify the given logo.", [
    "**RBSK — Rashtriya Bal Swasthya Karyakram** logo",
    "Launched: 2013 | Under: National Health Mission (NHM)",
    "Implementing body: Mobile Health Teams (MHTs) — 1 AYUSH doctor + 1 ANM/Female health worker per team",
])

story += q_row(2, "What is RBSK?", [
    "**Rashtriya Bal Swasthya Karyakram (RBSK)** = National Child Health Screening and Early Intervention Programme",
    "- Launched in 2013 under NHM",
    "- Goal: Early identification and FREE treatment of children (0–18 years) for selected health conditions",
    "- Covers 4 D's of childhood illness (see Q3)",
    "- Each district has a **DEIC (District Early Intervention Centre)** for comprehensive management",
])

story += q_row(3, "What are the 4 D's in children?", [
    "**1. Defects at Birth** — congenital conditions:",
    "   - CHD, Cleft lip/palate, Neural tube defects, Down's syndrome, Congenital cataract, Deafness, Club foot",
    "**2. Deficiencies** — nutritional deficiencies:",
    "   - Anaemia, Vitamin A deficiency, Vitamin D deficiency, Iodine deficiency",
    "**3. Diseases** — childhood diseases:",
    "   - Acute otitis media, Rheumatic heart disease, Reactive airway disease, Skin conditions",
    "**4. Developmental Delays including Disabilities:**",
    "   - Vision/hearing impairment, Neuromotor impairment, Cognitive impairment, Autism, Learning disabilities",
    ">>Mnemonic: 4D = Defects + Deficiencies + Diseases + Developmental delays",
])

story += q_row(4, "Who are the beneficiaries of RBSK?", [
    "Children from **birth (0) to 18 years** of age:",
    "- **0–6 weeks (Neonates):** screened at newborn care corners in delivery points",
    "- **6 weeks – 6 years:** screened at Anganwadi centres (AWCs)",
    "- **6 – 18 years:** screened at government and government-aided schools (twice a year)",
])

story += q_row(5, "What are the components of RBSK programme?", [
    "1. **Screening** — systematic health screening by Mobile Health Teams (MHTs)",
    "2. **Early Identification** — identification of children with 4D conditions",
    "3. **Referral** — to District Early Intervention Centre (DEIC) for comprehensive evaluation",
    "4. **Management & Rehabilitation** — free treatment, surgery, corrective services via DEIC + empanelled hospitals",
    "5. **Newborn Screening** — for congenital hypothyroidism, PKU, sickle cell disease, G6PD deficiency",
])
story.append(PageBreak())


# ══════════════════════════════════════════════════════════════════════════════
# SPOT 8 — Abhayrab Rabies Vaccine
# ══════════════════════════════════════════════════════════════════════════════
story += spot_header(8, "Abhayrab — Purified Vero Cell Rabies Vaccine", "Box of Abhayrab: Rabies Vaccine Human Cell Culture IP")
story.append(Spacer(1, 4))

story += q_row(1, "Write the dose of the vaccine.", [
    "**1 mL per dose** (intramuscular route)",
    "**0.1 mL per site** (intradermal route — 2 sites used)",
    "- Contains purified, inactivated rabies virus grown on Vero cells",
    "!!Do NOT use gluteal region — poor and unreliable immune response",
])

story += q_row(2, "Route of administration.", [
    "1. **Intramuscular (IM):** Deltoid muscle (adults) | Anterolateral thigh (children <2 years)",
    "2. **Intradermal (ID):** Approved, more economical (0.1 mL per site, 2 sites per visit)",
    "!!NEVER in gluteal / buttock region — fat reduces vaccine immunogenicity",
])

story += q_row(3, "Write schedule for this vaccine.", [])

story += simple_table(
    ["Protocol", "Route", "Schedule", "Doses"],
    [
        ["Essen (PEP)", "IM (1 mL)", "Days 0, 3, 7, 14, 28", "5 doses"],
        ["Zagreb (PEP)", "IM (1 mL)", "Day 0 (×2 sites), Day 7, Day 21", "4 doses"],
        ["ID 2-site (PEP)", "ID (0.1 mL × 2)", "Days 0, 3, 7, 28", "4 visits"],
        ["PrEP", "IM or ID", "Days 0, 7, 28", "3 doses"],
    ],
    col_widths=[3.5*cm, 3.0*cm, 6.0*cm, 2.5*cm]
)

story += q_row(4, "Write different categories of animal bite.", [])
story += simple_table(
    ["Category", "Description", "Management"],
    [
        ["I", "Touching/feeding animals; licks on INTACT skin", "Wash wound; NO vaccine needed"],
        ["II", "Minor scratches/abrasions without bleeding; nibbling uncovered skin", "Wound care + Vaccine (PEP)"],
        ["III", "Transdermal bites; mucous membrane contamination; licks on broken skin; bat exposure", "Wound care + Vaccine + HRIG"],
    ],
    col_widths=[1.8*cm, 7.5*cm, 6.7*cm]
)

story += q_row(5, "Dose of Human Rabies Immunoglobulin (HRIG).", [
    "**HRIG dose: 20 IU/kg body weight** (Category III bites only)",
    "- Infiltrate maximum amount into and around the wound",
    "- Remaining amount given IM at a site DISTANT from vaccine site",
    "- Given on **Day 0 ONLY** (with first vaccine dose) — never repeated",
    "- Equine RIG (ERIG): **40 IU/kg** body weight (cheaper but risk of serum sickness)",
    "!!If wound is on finger/toe, instil even then — do not force large volumes into closed space",
])
story.append(PageBreak())


# ══════════════════════════════════════════════════════════════════════════════
# SPOT 9 — DEIC / RBSK
# ══════════════════════════════════════════════════════════════════════════════
story += spot_header(9, "DEIC / RBSK — 5×5 Matrix", "No image — conceptual spot")
story.append(Spacer(1, 4))

story += q_row(1, "What is the full form of DEIC?", [
    "**DEIC = District Early Intervention Centre**",
    "- Established at District Hospitals under RBSK programme",
    "- Provides FREE comprehensive assessment, management, and rehabilitation",
    "- Serves children with 4D conditions referred by Mobile Health Teams (MHTs)",
    "**Services at DEIC:** Medical assessment, physiotherapy, speech therapy, psychological evaluation, corrective surgery referral",
])

story += q_row(2, "What are the 4 D's of RBSK?", [
    "1. **Defects at birth** — congenital anomalies (CHD, cleft, NTD, cataract, etc.)",
    "2. **Deficiencies** — nutritional (anaemia, Vit A, Vit D, iodine)",
    "3. **Diseases** — otitis media, RHD, reactive airway disease, skin conditions",
    "4. **Developmental delays including disabilities** — autism, vision/hearing loss, cognitive impairment",
    ">>4D Mnemonic: 'Deformities, Deficiencies, Diseases, Delays'",
])

story += q_row(3, "Enumerate any 3 points of 5×5 Matrix.", [
    "**5×5 Matrix = 5 Age Groups × 5 Domains/Conditions screened:**",
    "**5 Age Groups:**",
    "   1. 0–6 weeks | 2. 6 weeks–6 months | 3. 6 months–1 year | 4. 1–3 years | 5. 3–6 years (+ school children to 18)",
    "**5 Domains:** Defects at birth | Deficiencies | Diseases | Developmental delays | Disabilities",
    "**3 Key Points:**",
    "1. Neonates (0–6 weeks) screened for congenital conditions at delivery points/NRCs",
    "2. Children 6 weeks–6 years screened at Anganwadi Centres (AWCs) by MHTs",
    "3. Children 6–18 years screened at government schools TWICE A YEAR",
])

story += q_row(4, "Who are the beneficiaries of RBSK?", [
    "All children from **0 to 18 years** of age:",
    "- Neonates at delivery facilities",
    "- Children 6 weeks–6 years at AWCs",
    "- School children 6–18 years at government/aided schools",
    "Estimated **270 million children** covered nationwide",
])
story.append(PageBreak())


# ══════════════════════════════════════════════════════════════════════════════
# SPOT 10 — Goitre / IDD
# ══════════════════════════════════════════════════════════════════════════════
story += spot_header(10, "Goitre — Iodine Deficiency Disorder (IDD)", "Woman with visible neck swelling (goitre)")
story.append(Spacer(1, 4))

story += q_row(1, "Identify the disease.", [
    "**Goitre** — caused by Iodine Deficiency Disorder (IDD)",
    "- Visible/palpable enlargement of the thyroid gland",
    "- Simple/endemic goitre = diffuse, non-toxic enlargement due to dietary iodine deficiency",
    "- Grading: Grade 0 (no goitre) | Grade 1 (palpable only) | Grade 2 (visible at normal neck position)",
    "!!Endemic goitre = prevalence >5% in school-age children in a community",
])

story += q_row(2, "Name its national programme.", [
    "**National Iodine Deficiency Disorders Control Programme (NIDDCP)**",
    "- Previously: National Goitre Control Programme (NGCP) — renamed NIDDCP in **1992**",
    "**Main Strategy: Universal Salt Iodization (USI)**",
    "- Iodization at production level: **30 ppm** (mg/kg)",
    "- At point of consumption: minimum **15 ppm**",
    "- **Goal:** Reduce IDD prevalence to <10% and urinary iodine <20 µg/dL to <50%",
    "- Surveys: Every 5 years to assess magnitude of IDD",
    ">>Goitre rate >10% or urinary iodine <100 µg/L in >50% children = public health problem",
])

story += q_row(3, "Enumerate preventive measures.", [
    "1. **Universal Salt Iodization (USI)** — use of iodized salt; most effective and sustainable",
    "2. **Iodized oil** — oral capsules or IM injections (Lipiodol) for severely deficient/remote areas",
    "3. **Dietary diversification** — include iodine-rich foods: sea fish, seafood, dairy, eggs",
    "4. **Reduce goitrogens** — limit raw cabbage, turnips, cassava, soybean (contain thiocyanates/goitrin)",
    "5. **Regular IDD surveys and monitoring** — urinary iodine excretion (UIE) monitoring",
    ">>Target UIE: Median ≥100 µg/L in school-age children indicates adequate iodine intake",
])

story += q_row(4, "What is food fortification? Give two examples.", [
    "**Food Fortification:** Addition of one or more essential nutrients to a food (whether or not normally present) to prevent or correct a demonstrated deficiency in the population",
    "**Two examples:**",
    "1. **Iodized salt** — Potassium iodate/iodide added to common salt (prevents IDD/goitre)",
    "2. **Iron and folic acid-fortified atta (wheat flour)** — prevents iron deficiency anaemia",
    "Other examples: Vitamin A fortified cooking oil | Vitamin D fortified milk | Double-fortified salt (iodine + iron)",
    ">>Fortification ≠ Enrichment (enrichment restores nutrients lost during processing)",
])

story += q_row(5, "FSSAI stands for?", [
    "**FSSAI = Food Safety and Standards Authority of India**",
    "- Established under: **Food Safety and Standards Act, 2006**",
    "- Headquartered: New Delhi",
    "- Functions: Sets food standards; regulates manufacture, storage, distribution, sale and import of food",
    "- Logo: FSSAI logo is mandatory on all packaged foods in India",
    "!!FSSAI replaced earlier multiple acts (PFA Act, Fruit Products Order, Meat Food Products Order, etc.)",
])


# ── QUICK REVISION SUMMARY (last page) ────────────────────────────────────────
story.append(PageBreak())

summary_banner_data = [[Paragraph("QUICK REVISION SUMMARY", SPOT_TITLE)]]
summary_banner = Table(summary_banner_data, colWidths=[PAGE_W])
summary_banner.setStyle(TableStyle([
    ("BACKGROUND", (0,0), (-1,-1), ORANGE),
    ("TOPPADDING", (0,0), (-1,-1), 8),
    ("BOTTOMPADDING", (0,0), (-1,-1), 8),
    ("LEFTPADDING", (0,0), (-1,-1), 10),
    ("ROUNDEDCORNERS", [5]),
]))
story.append(summary_banner)
story.append(Spacer(1, 6))

mnemonics = [
    ("SPOT 1 — OCP",         "ACHES = Abdominal pain, Chest pain, Headache, Eye changes, Severe leg pain (warning signs for OCP)"),
    ("SPOT 2 — Aedes",       "DCYZ = Dengue, Chikungunya, Yellow fever, Zika | Lyre-shaped marking on thorax"),
    ("SPOT 3 — Horrock's",   "OT = Ortho-Tolidine | Residual Cl₂ = 0.5 ppm | Cup 3 = 2.5 g bleaching powder/1000 L"),
    ("SPOT 4 — Cold Chain",  "4 ice packs | Condition until condensation appears | AEFI = report in 24 hours"),
    ("SPOT 5 — BMW",         "Yellow = Incineration | Red = Autoclave | White = Sharps | Steps: S-C-L-T-S-T"),
    ("SPOT 6 — RTI/STI",     "6 coloured kits | Universal precautions for ALL patients | Disclose HIV to partner if risk of harm"),
    ("SPOT 7 — RBSK",        "4D = Defects + Deficiencies + Diseases + Delays | 0–18 yrs | DEIC at district level"),
    ("SPOT 8 — Rabies",      "Cat I = Wash | Cat II = Vaccine | Cat III = Vaccine + HRIG (20 IU/kg) | Essen: 0,3,7,14,28"),
    ("SPOT 9 — DEIC",        "DEIC = District Early Intervention Centre | 5×5 matrix | 270 million children covered"),
    ("SPOT 10 — Goitre",     "NIDDCP (1992) | USI = 30 ppm production, 15 ppm consumption | FSSAI = Food Safety Standards Authority of India"),
]

mdata = [[Paragraph(f"<b>{k}</b>", S("mk", fontName="Helvetica-Bold", fontSize=9, textColor=DARK_BLUE)),
          Paragraph(v, S("mv", fontName="Helvetica", fontSize=9, textColor=BLACK, leading=13))]
         for k, v in mnemonics]

mt = Table(mdata, colWidths=[4.2*cm, 11.8*cm])
mt.setStyle(TableStyle([
    ("ROWBACKGROUNDS", (0,0), (-1,-1), [LIGHT_BG, WHITE]),
    ("GRID",           (0,0), (-1,-1), 0.3, colors.HexColor("#C5CAE9")),
    ("TOPPADDING",     (0,0), (-1,-1), 5),
    ("BOTTOMPADDING",  (0,0), (-1,-1), 5),
    ("LEFTPADDING",    (0,0), (-1,-1), 6),
    ("VALIGN",         (0,0), (-1,-1), "MIDDLE"),
]))
story.append(mt)
story.append(Spacer(1, 10))
story.append(Paragraph(
    "Community Medicine Spotting Study Guide  •  Generated by Orris AI  •  All answers based on standard PSM / Preventive Medicine curriculum",
    FOOTER_NOTE
))


# ── BUILD ──────────────────────────────────────────────────────────────────────
doc.build(story)
print(f"PDF saved to: {OUTPUT_PATH}")

python3 /home/daytona/workspace/spotting_study_guide/generate_pdf.py

ls -lh /home/daytona/workspace/spotting_study_guide/Community_Medicine_Spotting_…