import matplotlib
matplotlib.use("Agg")
import matplotlib.pyplot as plt
import matplotlib.patches as mpatches
from matplotlib.patches import FancyBboxPatch, FancyArrowPatch
from matplotlib.backends.backend_pdf import PdfPages

OUT = "/tmp/workspace/diagnostic-flowchart/output/Diagnostic_Workup_Flowchart.pdf"

COLORS = {
    "title": "#1f3864",
    "assess": "#2e75b6",
    "labs": "#2e75b6",
    "decision": "#bf8f00",
    "branch": "#548235",
    "test": "#7f7f7f",
    "dx": "#c00000",
    "redflag": "#c00000",
}

def box(ax, x, y, w, h, text, color, fontsize=8.5, textcolor="white", weight="bold", style="round,pad=0.02,rounding_size=0.02", lw=1.4, alpha=1.0, fontstyle="normal"):
    b = FancyBboxPatch((x, y), w, h, boxstyle=style, linewidth=lw,
                        edgecolor=color, facecolor=color, alpha=alpha, zorder=2)
    ax.add_patch(b)
    ax.text(x + w/2, y + h/2, text, ha="center", va="center", fontsize=fontsize,
            color=textcolor, weight=weight, fontstyle=fontstyle, zorder=3, linespacing=1.3)
    return b

def outline_box(ax, x, y, w, h, text, edgecolor, fontsize=8, textcolor="black", lw=1.6, facecolor="white"):
    b = FancyBboxPatch((x, y), w, h, boxstyle="round,pad=0.02,rounding_size=0.02", linewidth=lw,
                        edgecolor=edgecolor, facecolor=facecolor, zorder=2)
    ax.add_patch(b)
    ax.text(x + w/2, y + h/2, text, ha="center", va="center", fontsize=fontsize,
            color=textcolor, zorder=3, linespacing=1.3)
    return b

def diamond(ax, cx, cy, w, h, text, color, fontsize=8.5, textcolor="white"):
    pts = [(cx, cy+h/2), (cx+w/2, cy), (cx, cy-h/2), (cx-w/2, cy)]
    d = mpatches.Polygon(pts, closed=True, facecolor=color, edgecolor=color, zorder=2)
    ax.add_patch(d)
    ax.text(cx, cy, text, ha="center", va="center", fontsize=fontsize, color=textcolor,
            weight="bold", zorder=3, linespacing=1.2)

def arrow(ax, x1, y1, x2, y2, color="black", lw=1.3, connectionstyle="arc3,rad=0.0"):
    a = FancyArrowPatch((x1, y1), (x2, y2), arrowstyle="-|>", mutation_scale=12,
                         color=color, linewidth=lw, connectionstyle=connectionstyle, zorder=1)
    ax.add_patch(a)

def new_page(figsize=(17, 11)):
    fig, ax = plt.subplots(figsize=figsize)
    ax.set_xlim(0, 100)
    ax.set_ylim(0, 65)
    ax.axis("off")
    return fig, ax

pdf = PdfPages(OUT)

# ============================================================
# PAGE 1: Triage -> Initial Workup -> Decision Point
# ============================================================
fig, ax = new_page()

ax.text(50, 63, "Diagnostic Workup Flowchart", ha="center", fontsize=20, weight="bold", color=COLORS["title"])
ax.text(50, 60.3, "Presenting complaint: Fever + Wet (productive) Cough + Joint Pain + Weakness",
        ha="center", fontsize=12.5, color="#333333", style="italic")

# STEP 0: Red flag screen
box(ax, 32, 54.5, 36, 4.6,
    "STEP 0 - IMMEDIATE RED-FLAG SCREEN\nHypotension / SpO2<92% / altered mental status / respiratory distress /\nnew murmur with embolic signs / signs of sepsis",
    COLORS["redflag"], fontsize=9)

arrow(ax, 50, 54.5, 50, 51.3)
outline_box(ax, 38, 48.8, 24, 2.6, "YES -> Any red flag present?", "#c00000", fontsize=8.5, textcolor="#c00000")

# split into urgent path and standard path
arrow(ax, 44, 48.8, 20, 46.5, connectionstyle="arc3,rad=-0.2")
arrow(ax, 56, 48.8, 78, 46.5, connectionstyle="arc3,rad=0.2")

box(ax, 6, 42.8, 28, 4.0, "YES: Admit / escalate to ED-ICU\nO2, IV access, sepsis workup,\nblood cultures x2, lactate,\nempiric broad-spectrum antibiotics",
    COLORS["redflag"], fontsize=8.3)

box(ax, 66, 43.3, 28, 3.4, "NO: Proceed with outpatient / ward\nstructured workup below", COLORS["assess"], fontsize=8.8)

arrow(ax, 80, 43.3, 50, 40.3)

# STEP 1: History + Exam
box(ax, 26, 35.8, 48, 4.6,
    "STEP 1 - FOCUSED HISTORY & EXAMINATION\n"
    "History: onset/duration, travel, water/animal exposure, sick contacts, recent sore throat,\n"
    "rash, IVDU, prior joint disease, medications  |  Exam: vitals, lung auscultation, joint\n"
    "pattern (mono/poly, migratory/fixed), skin/rash, cardiac murmur, lymphadenopathy",
    COLORS["assess"], fontsize=8.6)

arrow(ax, 50, 35.8, 50, 32.6)

# STEP 2: First-line labs/imaging
box(ax, 20, 28.0, 60, 4.6,
    "STEP 2 - FIRST-LINE LABS & IMAGING (all patients)\n"
    "CBC with differential, CRP/ESR, blood cultures x2, chest X-ray, urinalysis,\n"
    "renal/liver panel, flu + COVID-19 PCR/antigen, sputum Gram stain & culture",
    COLORS["labs"], fontsize=8.6)

arrow(ax, 50, 28.0, 50, 24.8)

diamond(ax, 50, 21.5, 34, 6.2, "STEP 3 - Which clinical pattern\ndominates on initial data?", COLORS["decision"], fontsize=9)

# Branches fan out to page 2 categories - draw 6 arrows down to labeled stubs
labels = [
    ("A: Infiltrate on\nCXR (pneumonia)", 8),
    ("B: Joint pain\ndominant, CXR clear", 24),
    ("C: Travel /\nexposure history +", 40),
    ("D: Cardiac findings /\nIVDU", 56),
    ("E: Chronic >2-4wk,\nweight loss", 72),
    ("F: Autoimmune\nfeatures (rash, etc.)", 88),
]
for text, xpos in labels:
    arrow(ax, 50, 18.4, xpos, 12.5, connectionstyle=f"arc3,rad={(xpos-50)/220}")
    outline_box(ax, xpos-8, 8.0, 16, 4.3, text, COLORS["branch"], fontsize=7.6, textcolor=COLORS["branch"])

ax.text(50, 2.8, "See Page 2 for branch-specific workup (A-F) and target diagnoses.  |  Page 1 of 2",
        ha="center", fontsize=9, color="#555555")

pdf.savefig(fig)
plt.close(fig)

# ============================================================
# PAGE 2: Branch-specific workups A-F
# ============================================================
fig, ax = new_page(figsize=(17, 13))
ax.set_ylim(0, 78)

ax.text(50, 76, "Branch-Specific Workup (continued from Page 1)", ha="center", fontsize=18, weight="bold", color=COLORS["title"])

def branch_block(ax, x, y, w, letter_title, tests, dx, h_title=3.0, h_tests=8.0, h_dx=3.2):
    box(ax, x, y, w, h_title, letter_title, COLORS["branch"], fontsize=9.3)
    arrow(ax, x+w/2, y, x+w/2, y-1.0)
    outline_box(ax, x, y-1.0-h_tests, w, h_tests, tests, "#7f7f7f", fontsize=7.6)
    arrow(ax, x+w/2, y-1.0-h_tests, x+w/2, y-1.0-h_tests-1.0)
    box(ax, x, y-2.0-h_tests-h_dx, w, h_dx, dx, COLORS["dx"], fontsize=8.2)

col_w = 28
gap = 4
start_x = 3
top_y = 70

branches = [
    ("BRANCH A\nInfiltrate on CXR\n(pneumonia pattern)",
     "Sputum culture + Gram stain\nAtypical panel: Mycoplasma serology,\nLegionella urinary antigen\nProcalcitonin (if available)\nIf arthralgia disproportionate/persists:\nASO titer, Anti-DNase B, ECG, Echo",
     "-> CAP (typical/atypical) with\nreactive arthralgia\n-> or superimposed rheumatic fever"),
    ("BRANCH B\nJoint pain dominant,\nCXR clear/minimal",
     "Joint pattern migratory?\n  Yes -> ASO/Anti-DNase B, ECG, Echo\n         (Jones criteria)\n  No, fixed/persistent -> RF, anti-CCP,\n         ANA, uric acid, joint aspirate\nRecent GI/GU infection? -> HLA-B27,\n         stool/urine culture",
     "-> Acute rheumatic fever\n-> Reactive arthritis\n-> RA / gout / SLE"),
    ("BRANCH C\nTravel / endemic\nexposure history +",
     "Tropical exposure:\n  Dengue NS1 antigen + IgM/IgG\n  Chikungunya IgM / RT-PCR\n  Malaria smear / RDT\nWater or animal exposure:\n  Leptospira serology (MAT), blood\n  and urine culture",
     "-> Dengue / Chikungunya\n-> Leptospirosis"),
    ("BRANCH D\nCardiac findings,\nIVDU, embolic signs",
     "Blood cultures x3 (before antibiotics)\nTransthoracic echo (TTE); TEE if\n  TTE inconclusive and suspicion high\nApply modified Duke criteria",
     "-> Infective endocarditis"),
    ("BRANCH E\nChronic symptoms\n(>2-4 wk), weight loss,\nnight sweats",
     "Sputum AFB smear/culture,\n  GeneXpert MTB/RIF\nChest CT if CXR equivocal\nJoint imaging if monoarticular\n  (Poncet's disease / skeletal TB)",
     "-> Pulmonary +/- osteoarticular\n     tuberculosis"),
    ("BRANCH F\nAutoimmune features\n(rash, oral ulcers,\nphotosensitivity)",
     "ANA, anti-dsDNA, complement\n  (C3/C4)\nUrinalysis for proteinuria/casts\nAnti-Ro/La, RF, anti-CCP as\n  indicated\nChest imaging for pleuritis/\n  pneumonitis",
     "-> SLE or other connective\n     tissue disease"),
]

for i, (title, tests, dx) in enumerate(branches):
    col = i % 3
    row = i // 3
    x = start_x + col*(col_w+gap)
    y = top_y - row*36
    branch_block(ax, x, y, col_w, title, tests, dx)

ax.text(50, 2.0,
        "Notes: This flowchart is a general educational reference, not a substitute for clinical judgment or local guidelines.\n"
        "Always correlate with full clinical context; multiple pathways may apply simultaneously. Page 2 of 2",
        ha="center", fontsize=8.3, color="#555555", linespacing=1.4)

pdf.savefig(fig)
plt.close(fig)

pdf.close()
print("Saved:", OUT)

import matplotlib
matplotlib.use("Agg")
import matplotlib.pyplot as plt
from matplotlib.patches import Rectangle, FancyBboxPatch
from matplotlib.backends.backend_pdf import PdfPages
import textwrap

OUT = "/tmp/workspace/diagnostic-flowchart/output/Clinical_Exam_Findings_Checklist.pdf"

def wrap_text(text, width=35):
    """Wrap text to specified width."""
    return '\n'.join(textwrap.wrap(text, width=width))

def header_box(ax, x, y, w, h, text, color="#1f3864"):
    """Draw a header box."""
    rect = FancyBboxPatch((x, y), w, h, boxstyle="round,pad=0.01", 
                          linewidth=1.8, edgecolor=color, facecolor=color, 
                          zorder=2)
    ax.add_patch(rect)
    ax.text(x + w/2, y + h/2, text, ha="center", va="center", 
            fontsize=10, color="white", weight="bold", zorder=3)

def diagnosis_box(ax, x, y, w, h, dx_name, color):
    """Draw a diagnosis name box."""
    rect = FancyBboxPatch((x, y), w, h, boxstyle="round,pad=0.008", 
                          linewidth=1.6, edgecolor=color, facecolor=color, 
                          zorder=2, alpha=0.85)
    ax.add_patch(rect)
    ax.text(x + w/2, y + h/2, dx_name, ha="center", va="center", 
            fontsize=9.5, color="white", weight="bold", zorder=3, linespacing=1.2)

def finding_row(ax, x, y, w, h, category, findings, color_cat="#e7e6e6", color_text="black"):
    """Draw a finding row with category and findings."""
    # Category label
    cat_w = w * 0.22
    rect_cat = Rectangle((x, y), cat_w, h, facecolor=color_cat, edgecolor="#999999", 
                         linewidth=1, zorder=1)
    ax.add_patch(rect_cat)
    ax.text(x + cat_w/2, y + h/2, category, ha="center", va="center", 
            fontsize=7.5, color="#333333", weight="bold", zorder=2, linespacing=1.1)
    
    # Findings text
    findings_w = w - cat_w
    rect_findings = Rectangle((x + cat_w, y), findings_w, h, facecolor="white", 
                             edgecolor="#cccccc", linewidth=0.8, zorder=1)
    ax.add_patch(rect_findings)
    ax.text(x + cat_w + 3, y + h/2, findings, ha="left", va="center", 
            fontsize=7.2, color=color_text, zorder=2, linespacing=1.15, family="monospace")

# ============================================================
# PAGE 1: Top 4 diagnoses
# ============================================================
pdf = PdfPages(OUT)
fig = plt.figure(figsize=(17, 22))
ax = fig.add_subplot(111)
ax.set_xlim(0, 100)
ax.set_ylim(0, 140)
ax.axis("off")

# Title
ax.text(50, 137, "Clinical Exam Findings Quick-Reference Checklist", 
        ha="center", fontsize=18, weight="bold", color="#1f3864")
ax.text(50, 134, "Fever + Cough + Joint Pain + Weakness: Differential Diagnosis", 
        ha="center", fontsize=11, style="italic", color="#555555")

# Column layout
col_w = 23
gap = 0.5
col_positions = [1, 25.5, 50, 74.5]

diagnoses_page1 = [
    {
        "name": "COMMUNITY-\nACQUIRED\nPNEUMONIA",
        "color": "#2e75b6",
        "findings": [
            ("Vital signs", "Tachypnea (RR>20), tachycardia,\nfever, hypoxia common"),
            ("Chest exam", "Crackles/rales, bronchial breath\nsounds, dullness to percussion,\nsplinting (pain with breath)"),
            ("Constitutional", "Malaise, fatigue, myalgia\ndisproportionate to joint pain"),
            ("Joints", "Arthralgias possible but NOT\nmigratory or severely inflamed"),
            ("Heart", "Normal S1/S2, no murmur (unless\nsecondary complication)"),
            ("Skin/rash", "None, or unrelated to pneumonia"),
            ("Red flags", "Hypoxia, altered mental status,\nhypotension, sepsis signs"),
        ]
    },
    {
        "name": "ACUTE\nRHEUMATIC\nFEVER",
        "color": "#c00000",
        "findings": [
            ("Vital signs", "Fever ~38-39°C, may be variable"),
            ("Joint exam", "MIGRATORY polyarthritis\n(moves between joints daily),\nno permanent damage"),
            ("Heart findings", "NEW murmur (aortic/mitral),\ncardiomegaly (CXR), pericardial\nfriction rub, signs of heart failure"),
            ("Skin", "Erythema marginatum (pale center,\nred border, non-pruritic) or\nsubcutaneous nodules"),
            ("Neuro", "Chorea (involuntary movements) if\npresent -> pathognomonic"),
            ("Chest exam", "Normal or signs of\ncardiomegaly/pulmonary edema"),
            ("ESR/CRP", "Both elevated (acute phase)"),
        ]
    },
    {
        "name": "INFECTIVE\nENDOCARDITIS",
        "color": "#bf8f00",
        "findings": [
            ("Vital signs", "Fever ~38-39°C, tachycardia"),
            ("Heart findings", "NEW or CHANGING murmur\n(regurgitant, high-pitched),\ncardiomegaly, signs of\ndecompensation"),
            ("Embolic phenomena", "Osler nodes (tender fingertip\nnodules), Janeway lesions\n(painless palmar macules),\nsplinter hemorrhages"),
            ("Petechiae", "Petechiae on conjunctiva, palate,\nextremities; retinal hemorrhages\n(Roth spots)"),
            ("Splenomegaly", "Palpable spleen"),
            ("Joint pain", "Arthralgias but NOT migratory or\ninflammatory; not a major finding"),
            ("Risk factors", "IVDU, prosthetic valve, recent\ndental/GI procedure"),
        ]
    },
    {
        "name": "SYSTEMIC\nLUPUS\nERYTHEMATOSUS",
        "color": "#70ad47",
        "findings": [
            ("Vital signs", "Fever, may be low-grade"),
            ("Skin findings", "MALAR rash (butterfly, spares\nnaso-labial folds), photosensitivity,\noral ulcers (painless), Raynaud's"),
            ("Joint exam", "Non-erosive polyarthritis\n(PIP/MCP/wrist), but NOT\nmigratory; may resemble RA"),
            ("Chest/lungs", "Pleuritis (pleuritic pain),\npleural effusion, pneumonitis,\ncan cause productive cough"),
            ("Other findings", "Lymphadenopathy, pericarditis,\nRenal involvement (proteinuria,\ncasts in UA)"),
            ("Hair/nails", "Alopecia, nail changes"),
            ("Constitutional", "Profound fatigue out of proportion\nto exam findings"),
        ]
    },
]

y_start = 131

for idx, dx in enumerate(diagnoses_page1):
    x = col_positions[idx % 4]
    y = y_start - (idx // 4) * 68
    
    # Diagnosis header
    diagnosis_box(ax, x, y - 2.5, col_w, 2.8, dx["name"], dx["color"])
    
    # Findings
    row_h = 8.0
    for i, (category, findings) in enumerate(dx["findings"]):
        finding_row(ax, x, y - 5.2 - i*row_h, col_w, row_h, category, findings)

ax.text(50, 1.5, "Page 1 of 2: Most Common & Acutely Differentiated Diagnoses",
        ha="center", fontsize=9, color="#555555", weight="bold")

pdf.savefig(fig, bbox_inches="tight", pad_inches=0.3)
plt.close(fig)

# ============================================================
# PAGE 2: Secondary & chronic diagnoses
# ============================================================
fig = plt.figure(figsize=(17, 22))
ax = fig.add_subplot(111)
ax.set_xlim(0, 100)
ax.set_ylim(0, 140)
ax.axis("off")

ax.text(50, 137, "Clinical Exam Findings Quick-Reference Checklist (continued)", 
        ha="center", fontsize=18, weight="bold", color="#1f3864")
ax.text(50, 134, "Additional Diagnoses to Consider", 
        ha="center", fontsize=11, style="italic", color="#555555")

diagnoses_page2 = [
    {
        "name": "DENGUE\nFEVER",
        "color": "#548235",
        "findings": [
            ("Vital signs", "HIGH fever (40-40.5°C),\nrelative bradycardia (characteristic)"),
            ("Joint/muscle pain", "SEVERE arthralgias & myalgias\n('breakbone fever'), weakness\nout of proportion"),
            ("Rash", "Rash appears on 3rd-4th day\n(face, trunk, extremities),\nspares palms/soles initially"),
            ("Bleeding signs", "Petechiae, mucosal bleeding\n(severe cases)"),
            ("Chest exam", "Minimal findings; cough not typical\nunless secondary pneumonia"),
            ("Lymph nodes", "Lymphadenopathy (cervical,\noccipital)"),
            ("Conjunctivitis", "Non-purulent conjunctival\ninjection without exudate"),
        ]
    },
    {
        "name": "CHIKUNGUNYA\nFEVER",
        "color": "#8b4789",
        "findings": [
            ("Vital signs", "Fever (often ~39-40°C),\ntachycardia"),
            ("Joint pain", "SEVERE, DEBILITATING\npolyarthritis (hands, feet, knees),\nmay persist weeks-months,\ntruly disabling"),
            ("Weakness/fatigue", "Profound fatigue & weakness,\noften bedbound early"),
            ("Rash", "Maculopapular, generalized,\noften pruritic, NO hemorrhagic\nfeatures usually"),
            ("Chest exam", "No specific findings; cough\nuncommon unless concurrent\ninfection"),
            ("Lymph nodes", "Mild or absent"),
            ("Travel hx", "CRITICAL: recent travel to\nendemic areas (Africa, Asia,\nCaribbean)"),
        ]
    },
    {
        "name": "TUBERCULOSIS\n(pulmonary +\njoint involvement)",
        "color": "#d99694",
        "findings": [
            ("Vital signs", "LOW-GRADE fever (afternoon spike),\nnight sweats, weight loss"),
            ("Chest exam", "Crackles apical (upper lobes),\ndull percussion if effusion,\nmay have minimal findings early"),
            ("Constitutional", "Profound weakness, fatigue,\nweight loss, malaise over weeks-months"),
            ("Joint exam", "Monoarticular or oligoarticular\n(hip, knee, ankle), warm, swollen,\nPoncet disease if rheumatic"),
            ("Lymph nodes", "Hilar or mediastinal (CXR),\nperipheral nodes possible"),
            ("Sputum", "Productive cough, may be\nblood-tinged (hemoptysis)"),
            ("Timeline", "CHRONIC onset (weeks-months),\nnot acute"),
        ]
    },
    {
        "name": "LEPTOSPIROSIS",
        "color": "#4472c4",
        "findings": [
            ("Vital signs", "Biphasic fever: high in 1st week,\nlull, then recurrence"),
            ("Chest exam", "Cough, possible pneumonia-like\nconsolidation (10-15% of cases)"),
            ("Joint/muscle pain", "Severe myalgias (especially\ncalves, shins), arthralgias,\nmarkedly painful"),
            ("Constitutional", "Headache, malaise, extreme weakness"),
            ("Renal signs", "If severe: jaundice, renal\ndysfunction (Weil disease),\nbleeding"),
            ("Eyes", "Conjunctival suffusion WITHOUT\nexudate (characteristic)"),
            ("Exposure hx", "CRITICAL: water exposure\n(floods, occupational), animal\ncontact (rodents, livestock)"),
        ]
    },
    {
        "name": "REACTIVE\nARTHRITIS\n(post-strep or\nother infection)",
        "color": "#ed7d31",
        "findings": [
            ("Vital signs", "Fever may be mild or absent"),
            ("Joint exam", "NON-MIGRATORY polyarthritis\n(asymmetric), usually lower\nlimbs (knees, ankles, feet)"),
            ("Onset", "Follows GI or GU infection by\n1-3 weeks (dysentery, chlamydia,\netc.) or respiratory infection"),
            ("Chest exam", "May have resolved respiratory\nsymptoms or lingering cough"),
            ("Conjunctivitis", "Possible (if Reiter variant)"),
            ("Urethritis", "May have dysuria history"),
            ("Rash", "Usually none; can have keratoderma\nblennorrhagicum"),
        ]
    },
    {
        "name": "ATYPICAL\nPNEUMONIA\n(Mycoplasma,\nLegionella)",
        "color": "#a9d08e",
        "findings": [
            ("Vital signs", "Fever, may be modest,\nmild tachypnea"),
            ("Chest exam", "Crackles/wheezing possible,\nbut often MINIMAL findings\ndespite significant infiltrate"),
            ("Constitutional", "Prominent headache, malaise,\nmyalgias, fatigue"),
            ("Joint pain", "Arthralgias/myalgias common,\nbut NOT primary complaint"),
            ("GI symptoms", "Nausea, diarrhea (esp. Legionella)"),
            ("Cough character", "Initially dry, becomes productive\nlater, may be prolonged"),
            ("CXR-exam mismatch", "CLASSIC: CXR shows consolidation\nbut minimal exam findings"),
        ]
    },
]

y_start = 131

for idx, dx in enumerate(diagnoses_page2):
    x = col_positions[idx % 4]
    y = y_start - (idx // 4) * 68
    
    # Diagnosis header
    diagnosis_box(ax, x, y - 2.5, col_w, 2.8, dx["name"], dx["color"])
    
    # Findings
    row_h = 8.0
    for i, (category, findings) in enumerate(dx["findings"]):
        finding_row(ax, x, y - 5.2 - i*row_h, col_w, row_h, category, findings)

# Footer: Key discriminators
footer_text = """
KEY DISCRIMINATORS:
• MIGRATORY joints + NEW cardiac murmur = ARF  |  • EMBOLIC signs (Osler/Janeway) + new murmur = IE  |  • MALAR rash + photosensitivity = SLE
• SEVERE disabling arthralgia + fatigue + travel to tropics = Chikungunya/Dengue  |  • CHRONIC (weeks-months) + weight loss = TB
• Normal exam with CXR infiltrate = Atypical pneumonia (Mycoplasma/Legionella)  |  • Post-infection +2-3wk lag = Reactive arthritis
"""
ax.text(50, 2.0, footer_text, ha="center", fontsize=8, color="#333333", 
        linespacing=1.4, bbox=dict(boxstyle="round,pad=0.8", facecolor="#fffacd", 
        edgecolor="#bf8f00", linewidth=1.5, alpha=0.9))

ax.text(50, 0.3, "Page 2 of 2: Less Common & Chronic Diagnoses  |  Use in conjunction with lab/imaging findings for definitive diagnosis",
        ha="center", fontsize=8.5, color="#555555", weight="bold", style="italic")

pdf.savefig(fig, bbox_inches="tight", pad_inches=0.3)
plt.close(fig)

pdf.close()
print("Saved:", OUT)