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  1. <div class="modal fade" tabindex="-1" role="dialog" id="modal-wizard-oto-dialog">
  2. <div class="modal-dialog modal-lg modal-95" role="document">
  3. <div class="modal-content">
  4. <div class="modal-header">
  5. <h5 class="modal-title"><?php echo _('Wizard Ear'); ?></h5>
  6. <button type="button" class="close" data-dismiss="modal" aria-label="Close">
  7. <span aria-hidden="true">&times;</span>
  8. </button>
  9. </div>
  10. <div class="modal-body">
  11. <div class="row">
  12. <div class="col-lg-6">
  13. <div class="row">
  14. <div class="col-lg-6 text-center">
  15. <div data-wrappertype="images-wrapper-oto" data-checkboxclass="oto-desease-check" class="derma-image-wrapper text-center <?php echo isset($this->view->otoImages['oto_myringitis']) ? 'wizard-images-selected' : ''; ?>" data-type="oto_myringitis">
  16. <div class="derma-title"><?php echo $this->view->otoPositionLabels['oto_myringitis']; ?></div>
  17. <img src="/images/wizards/oto/bullous-myringitis.jpg" alt="">
  18. <input type="checkbox" name="data[ear_desease][value][]" class="oto-desease-check" id="derma-position-check-oto_myringitis" class="derma-position-check" data-label="<?php echo $this->view->otoPositionLabels['oto_myringitis']; ?>" value="oto_myringitis" <?php echo isset($this->view->otoImages['oto_myringitis']) ? 'checked' : ''; ?>>
  19. </div>
  20. </div>
  21. <div class="col-lg-6 text-center">
  22. <div data-wrappertype="images-wrapper-oto" data-checkboxclass="oto-desease-check" class="derma-image-wrapper text-center <?php echo isset($this->view->otoImages['oto_polip']) ? 'wizard-images-selected' : ''; ?>" data-type="oto_polip">
  23. <div class="derma-title"><?php echo $this->view->otoPositionLabels['oto_polip']; ?></div>
  24. <img src="/images/wizards/oto/polyp-of-the-eac.jpg" alt="">
  25. <input type="checkbox" name="data[ear_desease][value][]" class="oto-desease-check" id="derma-position-check-oto_polip" class="derma-position-check" data-label="<?php echo $this->view->otoPositionLabels['oto_polip']; ?>" value="oto_polip" <?php echo isset($this->view->otoImages['oto_polip']) ? 'checked' : ''; ?>>
  26. </div>
  27. </div>
  28. </div>
  29. <div class="row">
  30. <div class="col-lg-6 text-center">
  31. <div data-wrappertype="images-wrapper-oto" data-checkboxclass="oto-desease-check" class="derma-image-wrapper text-center <?php echo isset($this->view->otoImages['oto_atelectasis']) ? 'wizard-images-selected' : ''; ?>" data-type="oto_atelectasis">
  32. <div class="derma-title"><?php echo $this->view->otoPositionLabels['oto_atelectasis']; ?></div>
  33. <img src="/images/wizards/oto/tympanic-atelectatis.jpg" alt="">
  34. <input type="checkbox" name="data[ear_desease][value][]" class="oto-desease-check" id="derma-position-check-oto_atelectasis" class="derma-position-check" data-label="<?php echo $this->view->otoPositionLabels['oto_atelectasis']; ?>" value="oto_atelectasis" <?php echo isset($this->view->otoImages['oto_atelectasis']) ? 'checked' : ''; ?>>
  35. </div>
  36. </div>
  37. <div class="col-lg-6 text-center">
  38. <div data-wrappertype="images-wrapper-oto" data-checkboxclass="oto-desease-check" class="derma-image-wrapper text-center <?php echo isset($this->view->otoImages['oto_perforation']) ? 'wizard-images-selected' : ''; ?>" data-type="oto_perforation">
  39. <div class="derma-title"><?php echo $this->view->otoPositionLabels['oto_perforation']; ?></div>
  40. <img src="/images/wizards/oto/perforation.jpg" alt="">
  41. <input type="checkbox" name="data[ear_desease][value][]" class="oto-desease-check" id="derma-position-check-oto_perforation" class="derma-position-check" data-label="<?php echo $this->view->otoPositionLabels['oto_perforation']; ?>" value="oto_perforation" <?php echo isset($this->view->otoImages['oto_perforation']) ? 'checked' : ''; ?>>
  42. </div>
  43. </div>
  44. </div>
  45. <div class="row">
  46. <div class="col-lg-6 text-center">
  47. <div data-wrappertype="images-wrapper-oto" data-checkboxclass="oto-desease-check" class="derma-image-wrapper text-center <?php echo isset($this->view->otoImages['oto_chole']) ? 'wizard-images-selected' : ''; ?>" data-type="oto_chole">
  48. <div class="derma-title"><?php echo $this->view->otoPositionLabels['oto_chole']; ?></div>
  49. <img src="/images/wizards/oto/cholesteatomatous-otitis-media.jpg" alt="">
  50. <input type="checkbox" name="data[ear_desease][value][]" class="oto-desease-check" id="derma-position-check-oto_chole" class="derma-position-check" data-label="<?php echo $this->view->otoPositionLabels['oto_chole']; ?>" value="oto_chole" <?php echo isset($this->view->otoImages['oto_chole']) ? 'checked' : ''; ?>>
  51. </div>
  52. </div>
  53. <div class="col-lg-6 text-center">
  54. <div data-wrappertype="images-wrapper-oto" data-checkboxclass="oto-desease-check" class="derma-image-wrapper text-center <?php echo isset($this->view->otoImages['oto_tympanoscler']) ? 'wizard-images-selected' : ''; ?>" data-type="oto_tympanoscler">
  55. <div class="derma-title"><?php echo $this->view->otoPositionLabels['oto_tympanoscler']; ?></div>
  56. <img src="/images/wizards/oto/tympanosclerosis.jpg" alt="">
  57. <input type="checkbox" name="data[ear_desease][value][]" class="oto-desease-check" id="derma-position-check-oto_tympanoscler" class="derma-position-check" data-label="<?php echo $this->view->otoPositionLabels['oto_tympanoscler']; ?>" value="oto_tympanoscler" <?php echo isset($this->view->otoImages['oto_tympanoscler']) ? 'checked' : ''; ?>>
  58. </div>
  59. </div>
  60. </div>
  61. <div class="row">
  62. <div class="col-lg-6 text-center">
  63. <div data-wrappertype="images-wrapper-oto" data-checkboxclass="oto-desease-check" class="derma-image-wrapper text-center <?php echo isset($this->view->otoImages['oto_tyjugular']) ? 'wizard-images-selected' : ''; ?>" data-type="oto_tyjugular">
  64. <div class="derma-title"><?php echo $this->view->otoPositionLabels['oto_tyjugular']; ?></div>
  65. <img src="/images/wizards/oto/tympano-jugular.jpg" alt="">
  66. <input type="checkbox" name="data[ear_desease][value][]" class="oto-desease-check" id="derma-position-check-oto_tyjugular" class="derma-position-check" data-label="<?php echo $this->view->otoPositionLabels['oto_tyjugular']; ?>" value="oto_tyjugular" <?php echo isset($this->view->otoImages['oto_tyjugular']) ? 'checked' : ''; ?>>
  67. </div>
  68. </div>
  69. <div class="col-lg-6 text-center">
  70. <div data-wrappertype="images-wrapper-oto" data-checkboxclass="oto-desease-check" class="derma-image-wrapper text-center <?php echo isset($this->view->otoImages['oto_cholesterol']) ? 'wizard-images-selected' : ''; ?>" data-type="oto_cholesterol">
  71. <div class="derma-title"><?php echo $this->view->otoPositionLabels['oto_cholesterol']; ?></div>
  72. <img src="/images/wizards/oto/cholesterol-granuloma.jpg" alt="">
  73. <input type="checkbox" name="data[ear_desease][value][]" class="oto-desease-check" id="derma-position-check-oto_cholesterol" class="derma-position-check" data-label="<?php echo $this->view->otoPositionLabels['oto_cholesterol']; ?>" value="oto_cholesterol" <?php echo isset($this->view->otoImages['oto_cholesterol']) ? 'checked' : ''; ?>>
  74. </div>
  75. </div>
  76. </div>
  77. </div>
  78. <div class="col-lg-6">
  79. <div class="row">
  80. <div class="col"><?php echo $this->helper->getRequestExam($this->view->exams, 'Ear Symptoms', 'oto'); ?></div>
  81. </div>
  82. <hr>
  83. <div class="row">
  84. <div class="col"><?php echo $this->helper->getRequestExam($this->view->exams, 'Associated symptoms', 'oto'); ?></div>
  85. </div>
  86. <div class="strike-center"><span><?php echo _('Otological examination'); ?></span></div>
  87. <div class="margin-bottom-20"></div>
  88. <div class="wiazard-ident-list">
  89. <div class="row">
  90. <div class="col"><?php echo $this->helper->getRequestExam($this->view->exams, 'Pinna/pre/retroauricular region', 'oto'); ?></div>
  91. </div>
  92. <hr>
  93. <div class="row">
  94. <div class="col"><?php echo $this->helper->getRequestExam($this->view->exams, 'External auditory canal (EAC)', 'oto'); ?></div>
  95. </div>
  96. <hr>
  97. <div class="row">
  98. <div class="col"><?php echo $this->helper->getRequestExam($this->view->exams, 'Tympanic membrane (Eardrum)', 'oto'); ?></div>
  99. </div>
  100. <hr>
  101. <div class="row">
  102. <div class="col"><?php echo $this->helper->getRequestExam($this->view->exams, 'Middle ear', 'oto'); ?></div>
  103. </div>
  104. <hr>
  105. <div class="row">
  106. <div class="col"><?php echo $this->helper->getRequestExam($this->view->exams, 'Tuning fork tests', 'oto'); ?></div>
  107. </div>
  108. </div>
  109. <div class="strike-center"><span><?php echo _('Vestibular system'); ?></span></div>
  110. <div class="margin-bottom-20"></div>
  111. <div class="wiazard-ident-list">
  112. <div class="row">
  113. <div class="col"><?php echo $this->helper->getRequestExam($this->view->exams, 'Eye movements', 'oto'); ?></div>
  114. </div>
  115. <hr>
  116. <div class="row">
  117. <div class="col"><?php echo $this->helper->getRequestExam($this->view->exams, 'Vestibulo-occular reflex', 'oto'); ?></div>
  118. </div>
  119. <hr>
  120. <div class="row">
  121. <div class="col"><?php echo $this->helper->getRequestExam($this->view->exams, 'Vestibulo-spinal reflex', 'oto'); ?></div>
  122. </div>
  123. </div>
  124. <hr>
  125. <div class="row">
  126. <div class="col"><?php echo $this->helper->getRequestExam($this->view->exams, 'Cranial nerves examination', 'oto'); ?></div>
  127. </div>
  128. </div>
  129. </div>
  130. </div>
  131. <div class="modal-footer">
  132. <button type="button" class="btn btn-primary" data-dismiss="modal"><?php echo _('Done'); ?></button>
  133. </div>
  134. </div>
  135. </div>
  136. </div>