bluuebunny/crossref_metadata_2025 huggingface dataset:
Occupational noise induced hearing loss among local industrial population in Kashmir: a lifestyle study
Authors: Sheikh Imran , Ali Ihsan , Makhdoomi Owais , Wani Rabbanie Tariq
Published: June 2018

Background: The purpose of this observational study was to evaluate the incidence of occupational noise induced hearing loss (ONIHL) among the local industrial population of Kashmir who are involved in occupations exposed to noise.

Methods: This prospective observational study was conducted in the department of ENT&HNS of government medical college Srinagar and SMHS Hospital. Total of 508 patients were screened and 158 patients were found have ONIHL patients were included in this study. The study population was evaluated for any significant history and were subjected thorough ENT assessment which included history, clinical examination, Otoscopic examination and then a pure tone audiometry. All these patients were further evaluated with a questionnaire in addition to clinical examination.  

Results: Around 31% (158) participants were found to have occupational noise induced hearing loss. The highest incidence of hearing loss was found in 50-59 years age group, which was 0.61. The industrial distribution of occupational noise induced hearing loss (ONIHL) in the screened population in the community was found maximum among Bandsaws workers with ONIHL, contributing 30.37% to the total. ONIHL was found to be most common (64.28%) in individuals exposed to loud noise for maximum duration of time (>20 yrs), while it was least common (20.34%) in individuals exposed to loud noise for least duration of time (<5 yrs).
Conclusions: Our study concluded that people who are exposed to noise more than 90db for more than 8 hours day working in local industries of Kashmir have high frequency sensorineural hearing loss.
Study the etiopathogenesis and management of epistaxis
Authors: Rao J. Sreenivasa , Rao U. Srinivasa , Chandra T. Sateesh
Published: June 2018

Background: The aim of the study was to study the etiopathogenesis, age and sex distribution and management, chemical cautery, anterior and posterior nasal packing, nasal septal surgery, blood transfusion and arterial ligation.

Methods: It is simple random sampling study undertaken to know the etiopathogenesis and management of epistaxis at government general hospital for 2 years.  

Results: The incidence of epistaxis was 1.5%. It was more in males with a male to female ratio of 1:9:1. The age incidence was more in the first and second decades and then increased from the fourth onwards with almost 60% cases belonging to this category. The seasonal incidence was more during cold, dry, winter months (70%). The commonest etiological factor was trauma (42%), followed by the hypertension (24%). 72% of patients had anterior nasal bleeding. The treatment options were divided onto non- surgical and surgical modalities. 86% of the patients were managed by conservative measures like medical treatment (42%) cautery (6%), anterior nasal packing (30%) and posterior nasal packing (4%). 14% of the patients required surgical intervention like septoplasty (2%), excision of bleeding nasal polypus (2%), nasal bone fracture reduction (2%), excision of adenoid cystic carcinoma of nose (2%), removal of rhinolith (92%), excision of angiofibroma of nose (4%).

Conclusions: Anterior bleeding is more common and trauma is an important etiological factor. Majority cases of epistaxis are managable by conservative measures and only few require surgical intervention. 
Tympanoplasty revolutionized: my experience with a series of 500 cases
Authors: Krishnan G. Sundhar , Joseph Nisha Alice
Published: June 2018

Background: Tympanoplasty has been the mainstay in management of chronic suppurative otitis media for decades with invent of microscopes in ear surgeries, which traditionally have been giving good results when in good hands. However, after the introduction of endoscopes in the field of otology, it has completely revolutionized my outlook and approach to the pathophysiology of the disease as well as its management. The aim of the present study was to discuss the advantages of endoscopes over microscopes and the science of endoscopic minimally invasive middle ear surgery.

Methods: A retrospective study was conducted on 500 cases where we did endoscopic endomeatal tympanoplasty for chronic suppurative otitis media – mucosal type with central perforation, between May 1996 and May 2017 in our tertiary medical centre.

Results: Among 500 cases operated, 99 % of our cases had excellent graft take up. Pure tone audiometry done before and after 2 month of surgery showed an improvement in the conductive hearing with reduced air bone gap. 97% patients with moderate conductive hearing loss had their hearing within normal limit postoperatively. Endoscope provided better visualization, avoided canalplasty, reduced operative time, shorter hospital stay and was cost effective

Conclusions: Minimally invasive endoscopic tympanoplasty provided better visualization, avoided canalplasty, reduced operative time, shorter hospital stay and was cost effective and thereby finds itself at a futuristic level over microscopes. Nevertheless, it does require a long learning curve, and experience to expertise for optimal patient satisfaction and overcome complications.
Effect of canalplasty in tympanoplasty
Authors: Prakash M. D. , Badkar Priya
Published: June 2018

Background: Objective of the study was to analyse the role of canalplasty in tympanoplasty in terms of intra operative ease, complete visualisation of tympanic membrane, graft uptake rates and hearing improvement.

Methods: 100 patients with chronic otitis media presenting to our institution from August 2016 to July 2017 were included in this study. Group I consisted of 50 patients who underwent tympanoplasty with canalplasty and Group II had 50 patients who underwent tympanoplasty without canalplasty. Both groups were followed up for 3 months, compared and analysed for hearing improvement and graft uptake.  

Results: Our results showed that Group I achieved 98% graft uptake rates compared to group II which achieved 92%. In Group II gain in air bone gap was 11.26 dB where as in Group I was about 13.48 dB. Group I had significant hearing improvement compared to Group II.

Conclusions: It is advisable to combine canalplasty with tympanoplasty as it gives better visualisation of tympanic membrane facilitating the placement of graft and prevents lateralization of the graft. 
Prevalence of self probing, clinical presentation and the causative organism among the patients presented with otitis externa in a tertiary care hospital
Authors: Rameshkumar Edakkattil , Ajitha Salini
Published: June 2018

Background: Otitis externa, an inflammatory condition commonly reported in almost all age groups. But the prevalence and etiology are varying on different region. This study was aimed to find out the prevalence of self probing, clinical presentation and the causative organism among the patients presented with otitis externa in a tertiary care hospital.

Methods: All the patients presented with otitis externa in the outpatient department of ENT were included in the retrospective study. The history of self probing was identified using a questionnaire. The clinical presentation was noticed and organism was isolated from the swab taken from the external ear canal. The non-parametric data was expressed in numbers and percentage.  

Results: Total 49 patients were included in the study. The average age of patient was 39.5±14.3 years with 24 males and remaining females. Among them, 85.7% (42/49) had a history of self probing (p<0.05). The most prevalent age group for the self probing associated otitis externa was 31 to 40 years. The discharge was the major clinical presentation (40/49) and the common organism isolated was Pseudomonas aeruginosa in 38% of incidence.

Conclusions: Self probing was major etiological factor for otitis externa in the age group of 31-40 years. Discharge was the major clinical presentation and the common organism isolated was Pseudomonas aeruginosa. This emphasized the need for a proper awareness programme in the society against self probing to reduce the incidence.
Invasive fungal sinusitis-analysis of management scenario
Authors: Dutta Prishni Devi , Belaldvar B. P. , Patil R. N.
Published: June 2018

Background: The objective of the study was to analyse the outcomes after therapeutic treatment of invasive fungal sinusitis.

Methods: A cross-sectional study consisting of 30 patients from January 2015-December 2005 in Jawaharlal Nehru medical college, department of ENT, Belagavi. Antifungal drugs were used like Amphotericin B-both non-liposomal & liposomal variety, and analysis of various parameters like its duration, efficacy and dosage was done in determining the prognosis.  

Results: The liposomal type of amphotericin B (AmBisone), which was used in 23 patients (76.6%) had a response rate of 65% and failure rate of 26%, with minimum dose of 50 mg/day to maximum dose of 200 mg/day. The maximum number of days used was for 46 days in 18 cases, which showed the effectiveness in controlling the infection. Amphotericin B deoxycholate (Fungizone) was used in 6 patients (20%) with response rate of 50% and failure rate of 33.3% and maximum dose given was 25 mg/day keeping a track of the renal profile. The total duration of treatment with Fungizone was for 14 days.

Conclusions: Along with surgical intervention, we were able to combat this fatal disease in 56% patients which was the overall survival rate and liposomal variety was preferred as majority of the patients had deranged renal parameters on presentation. But certain constraints like non-affordability by poor patients, cost-effectiveness on long term usage, were there. So further studies about the availability of more safer and affordable antifungals should be done. 
The correlation of the severity of polysomnography with clinical assessment in cases of adult OSA in a tertiary hospital
Authors: V. Suresh , M. Gowri Shankar , D. Prabhu , S. Natarajan
Published: June 2018

Background: Now days increasing number of people with sleep related breathing disorders especially obstructive sleep apnea are reporting every day in our institute, which is a tertiary referral centre. The objective was to correlate between clinical assessment andpolysomnographic features in an obstructive sleep apnea patient.

Methods: A total number of 60 cases were analyzed retrospectively and those who were already clinically assessed and diagnosed as OSA by AHI>5/h in overnight PSG study. The clinical history, body mass index, Epworth sleepiness scale score and full night polysomnograpic data were obtained for all 60 cases. The age and gender differences in OSA cases were analyzed. The correlations between the BMI, ESS score, AHI, oxygen saturation sleep apnea, Epworth sleeps scale and apnea hypopnea index were explored.  

Results: Of the 60 cases OSA were analyzed, the mean (SD) age was 36.62 (±11.90) years and the men was mostly affected 96.7% than women only 3.3%. Of 60 cases, 30% of patients having mild form, 25% of patients moderate form, 45% of patients having severe form. The obese patients affected more 83.3% (50/60) than normal only 10% (6/60). The clinical symptom were analyzed by ESS score the normal 18.3%, mild 18.3%, moderate 28.3% and severe 35%. The mean oxygen saturation and heart rate of OSA patients were 72.35 (±11.47) and 69.90 (±15.26) respectively.

Conclusions: The BMI and ESS score were positively correlated with severity of OSA. The oxygen saturation and heart rate were negatively correlated with OSA. 
Endoscopic DCR with and without prolene stent in rural area: a prospective randomized study
Authors: Kumar Abhay , Porwal Prateek Kumar , Dubey Kailash Prasad , Singh Harshita
Published: June 2018

Background: The objective of the study was to compare the results of endoscopic DCR with and without prolene stenting and to assess subjective and anatomical success in patients undergoing prolene stenting.

Methods: The surgical outcomes of endoscopic endonasal DCR was compared in 100 patients of chronic dacryocystitis with nasolacrimal duct obstruction from June 2013 to May 2018. The successful outcome of surgery was defined by subjective improvement of symptoms and anatomical patency of the neo-ostium on syringing by nasal endoscopy.  

Results: In our study females were predominant in both groups with around 60% being females in group with stenting and 64% in group without stenting. Male to female ratio was 1:1.5 and 1:1.77 in group with stenting and without stenting. The symptomatic success rate of the surgery at the end of 3 months was 92% in group without stenting and 88% in group with stenting. There was no statistical difference in the results of two groups.

Conclusions: We recommend that stenting is not routinely required for endoscopic DCR surgeries. A selective stenting approach may be advocated using prolene 3-0, using stenting for specific indications. With proper surgical technique and good follow up, endoscopic DCR without stenting is treatment of choice for chronic nasolacrimal duct obstruction.
Nicorandil ulcer: a frequent diagnosis, a rare etiology
Authors: Monteiro Francisco C. , Oliveira Pedro J. , Domingues Bruno F. , Condé Artur
Published: June 2018

Oral ulcers are a relatively frequent diagnosis in otolaryngology practice. They may have a vast etiology, the iatrogenic medication one of them nicorandil is an anti-ischemic drug used in coronary artery disease and is frequently used in combination with other anti-anginal drugs. There are reports of the association between nicorandil and the appearance of painful oral ulcers, with repercussion on patients' quality of life. The authors describe a case of a 76-year-old man man with ischemic heart disease past that presented to the emergency department complaining of ulcers on the tongue with 1 week of evolution. He had been medicated with long-standing nicorandil, however he had increased the dose one month before the urge of lesions. He was treated with topical corticosteroid and anti-fungal, with no response. The objective examination showed three ulcerated lesions in the tongue. Given the characteristics of the lesions and absence of response to therapy previously instituted, biopsies were performed. The histopathological results showed nonspecific ulceration aspects. Discussed the case with his Cardiologist and, given the temporal association between increased nicorandil dose and the appearance of the lesions, we decided for the drug suspension. In the revaluation after two weeks, there was favorable evolution, and 45 days after, the lesions had completely disappeared. For the diagnosis of oral ulcers, being of extremely importance to exclude neoplastic causes, it is relevant not to forget also the rarest etiologies, which although difficult to identify, may lead to a better quality of life and less use of medical care. 
 
Unusual foreign bodies of the airway: a case series regarding their management
Authors: Ullal Aishwarya , Mishra Sanjeev , Mundra R. K.
Published: June 2018

Foreign bodies in the bronchi are a common problem seen by ENT surgeons. Bronchial foreign bodies are common in children because they have difficulty in swallowing hard foodstuffs such as nuts and have an inadequately developed protective respiratory reflexes, which makes them vulnerable to inhalation of foreign bodies This is a case series of four unusual cases of foreign body airway, that presented to our ENT OPD, after taking detailed history and clinical examination, these patients were subjected to radiological studies such as chest X-rays, X-ray soft tissue lateral view, virtual bronchoscopy and CT chest to confirm the foreign body, after taking informed consent rigid bronchoscopy was performed and foreign body extracted.
Osteoma of mastoid temporal bone
Authors: M. Gowri Sankar , B. M. Somanath , Gadag Raveendra P. , C. B. Manu , M. Nagaraj
Published: June 2018

Osteoma is a benign slow growing bone tumour with predominance in long bones, and is rare in the skull. They are a rare occurrence in the mastoid temporal bone, being usually asymptomatic and treated mainly for cosmetic reasons. We report a case of a young female who presented with a history of swelling in the left post aural region since 10 years. Swelling was gradually increasing in size and was painless. Patient underwent excision of the tumour without any significant complication. As per our knowledge this appears to be the largest tumour reported in literature. The clinical presentation and radiological features of osteoma are characteristic but differential diagnosis should include eosinophilic granuloma, giant cell tumour, monostotic fibrous dysplasia, solitary variant of multiple osteoma, and osteoblastic metastasis. Osteomas present on the mastoid or squamous portion of the temporal bone need to be dealt for cosmetic purposes or if they are causing symptoms, while surgery should include careful removal of periosteal cover and safe margin of the mastoid cortex around it. 
Metastatic neck node: a straying journey to diagnosis
Authors: Galagali J. R. , Singh Roohie
Published: June 2018

Squamous cell carcinoma of lung is most commonly associated with smoking. Its metastasis to contralateral neck node as the first presenting symptom is very rare. Tuberculosis (TB) and cancer of lung have causal relationship. There may also be coexistence of another neoplasm around the time of diagnosis of primary neoplasm. We present a case report of an 80 years old man who presented with a contralateral metastatic neck node. He was diagnosed to have coexistent lung cancer and pulmonary TB. In this journey towards diagnosis, the findings suggestive of tubercular larynx might have been a sequel of pulmonary TB.
Isolated paraglottic neurofibroma; lateral thyrotomy approach: a case report
Authors: Naik Archan Devidas , Lambor Dheeraj , Shetgaunkar Radhika
Published: June 2018

Isolated neurofibromas are rare tumours of the paraglottic space. A 59 year old lady presented with progressive hoarseness for 5 years. Examination revealed a smooth submucosal globular mass in the glottosupraglottic region on the left side. After confirming findings on a contrast CT scan lateral thyrotomy approach was employed to excise the tumour in toto. Histopathology revealed a neurofibroma. Further workup to exclude neurofibromatosis (NF1) was done. Isolated laryngeal neurofibromas present a challenge to surgeons for providing complete excision of tumour while giving a good voice quality and lateral thyrotomy approach is the ideal approach for satisfying both these parameters.
Giant fronto-ethmoidal osteoma with orbital and intracranial extension: a case report
Authors: Gade Prashant S. , Velho Vernon , Naik Harish , Jain Nimesh
Published: June 2018

Osteomas of the paranasal sinuses are often small, asymptomatic and incidentally diagnosed on radiological imaging. Giant osteomas, although rare, are clinically significant due to their propensity to cause orbital and intracranial complications. Complete surgical resection is usually possible with good outcome and low recurrence rate. We report a case of 62 years female who presented with proptosis and blurring of vision. Radiological work up revealed giant fronto-ethmoidal osteoma measuring 7.9×5.1×4.8 cm extending into the orbit and along the anterior skull base. Open surgical excision of the osteoma was done via left fronto-orbital approach. This is one of the largest fronto-ethmoidal osteomas reported in the literature till date.
Mycotic pseudoaneurysm mimicking carotid body tumor
Authors: Solav Shrikant V. , Patil Abhijit M. , Savale Shailendra V. , Shinde Suresh N.
Published: June 2018

Masses in carotid space can be of varied etiology. These usually displace the parapharyngeal space anteriorly. They can arise from various structures and may be cystic or solid. Carotid body tumors are neural crest in origin and usually cause splaying of carotid vessels resulting is “Lyre sign”. Presented in this case report is a hypermetabolic mass resulting from mycotic aneurysm mimicking carotid body tumor. 
Retrieval of foreign body bronchus in paediatric age group: a challenge
Authors: Dwivedi Gunjan , Gupta Vikas , Dwivedi Deepak , Sood Amit , Upadhyay Madhukar , Kumar Manoj
Published: June 2018

Foreign body (FB) aspiration can be a cause of serious morbidity and occasional mortality in pediatric population. Sometimes the diagnosis is delayed when the history of FB aspiration is not forthcoming, not witnessed or when parents fail to appreciate the symptoms. Unless there is a high degree of suspicion these cases may easily be missed and may be treated for a prolonged duration as upper respiratory tract infection (URTI) or pneumonia.  A careful history plus a high degree of clinical suspicion is crucial. Involvement of other specialties is the key to diagnose and remove a FB from airway successfully. We present a case series of three cases of FB bronchus and challenges faced during their retrieval. The aim of this report is to highlight the importance of history taking, meticulous preparation, and precision required to remove a foreign body bronchus.
Comparative study between functional outcome of lumbar canal stenosis treated with surgical decompression by laminectomy and unilateral partial hemi laminectomy approaches
Authors: Ramesh K. , Vimalan G.
Published: June 2018

Background: Lumbar spinal canal stenosis may eventually cause signs of intermittent neurogenic claudication. The surgical options include procedures such as midline decompression by laminectomy and different kinds of unilateral and bilateral fenestrations and partial or full hemi laminectomies. The aim of the study is to unilateral decompressive approach provides the sufficient decompression; less invasive unilateral procedure, which preserves posterior musculoligamentous complex and bony structures reduce associated morbidity.

Methods: 41 patients underwent preoperative assessment of Japanese orthopaedic association score (JOA Score), Neurogenic claudication outcome scores (NCOS), visual analogy scale for back pain and neurogenic claudication. Patients were randomized to undergo either unilateral decompression by partial hemi laminectomy or CMD (CMD) by laminectomy. 20 patients was randomized into unilateral decompression by partial hemi laminectomy group and 21 patients into CMD (CMD) by laminectomy group.

Results: The mean JOA recovery rate was 50.61% for the unilateral decompression group and 52.12% for the CMD group. Notably, 62% of CMD group had good or excellent outcome while 70% of unilateral decompression group had a good or excellent outcome.

Conclusions: In our study, unilateral decompression by a partial hemi laminectomy provides minimal exposure for decompression in lumbar canal stenosis while preserving musculoligamentous attachments of the posterior elements of the spine and good postoperative results after one year with favorable outcomes of at least 70%. 
Ponseti technique: efficacy in idiopathic clubfoot in Indian population
Authors: Mahajan Neetin , Ramteke Ujwal , Gavhale Sandeep , Palange Nikhil , Mane Akash , Dave Harshit
Published: June 2018

Background: The number of operations for clubfoot is many, but the results are not encouraging and more complications are encountered after operative treatment. Most surgeons believe manipulation to be easy; however they rarely complete the treatment and abandon it and go on to surgery. In the confusing scenario Ponseti Method evolved and proved across the world to be one of the most promising ways to correct club foot with low cost minimum surgery and good result in short period of time.

Methods: 50 cases of idiopathic clubfeet (76 feet) were enrolled from a period of May 2006 to May 2008 in the department of Orthopaedic. Out of 50, 42 patients were followed-up for two years. Post tenotomy follow-up done every monthly for 3 months. At every visit babies were checked for any relapse and parents were counselled for the strict compliance with Foot Abduction Brace. The results of correction in 42 patients (64 feets) evaluated and compared with Ponseti's observation and other form of conservative management.

Results: The analysis of results of correction of clubfeet deformity by Ponseti's method reveals around 95.30% of good to acceptable result as compared with Ponseti’s observation of around 99% which is comparable. We have observed 4.69% of poor result as compared with 1% observed by Ponseti.

Conclusions: It is safe, efficient, Economical and most effective treatment for clubfoot which decreases the need for extensive corrective surgery. This technique can be used in children up to one year of age even after previous unsuccessful non-surgical treatment.
Arthroscopic treatment of displaced tibial eminence fractures using wire loop technique
Authors: Nirkhe Rajat , Sheth Hardik , Pathak Subodh Kumar , Barve Raghav , Gour Sandeep Kumar , M. Prashanth Raj
Published: June 2018

Background: Several techniques of arthroscopic treatment of tibial spine avulsion fractures have been described in the literature. We conducted a study to analyze the results of arthroscopic assisted wire loop technique for treatment of tibial spine avulsion in adults and pediatric patients.

Methods: From June 2011 to December 2016, 52 patients with tibial spine fractures were surgically treated with arthroscopic reduction and wire loop fixation. Forty-four patients were adults and eight were in their pediatric age group. The age group ranged from 9 years to 52 years with the mean age of 26.2 years. 28 patients were type 2 and 24 were of type 3 fracture as classified by Myeres and Mckeever’s classification. The final analysis was done using clinical tests, radiological evaluation and International Knee Documentation Committee (IKDC) and Lysholm score.

Results: At final follow-up, the mean IKDC and Lysholm knee scores were, 92 and 93 respectively. All patients had a complete functional recovery and were able to return to work and to resume their activities.

Conclusions: Arthroscopic wire loop fixation is an excellent method for tibial eminence fracture in adults and children which gives excellent results in form of control tension on ACL on each side of avulsed fragment and also gives adequate mechanical strength for early rehabilitation.
Autologous whole blood injection in chronic plantar fasciitis: a prospective clinical study
Authors: Kirmani Tabish Tahir , Gul Irfan Andleeb , Manzoor Qazi Waris , Kangoo Khurshid Ahmad
Published: June 2018

Background: Plantar fasciitis represents painful inflammatory process of plantar fascia with pain beneath the heel. The disease is frustrating for both the patient and the physician as the etiology is unknown. Conservative management is the mainstay of treatment. Patients with resistant pain can be treated with local injections. In this study we evaluated the effectiveness of autologous whole blood injection for treatment of chronic plantar fasciitis.

Methods: The study was conducted on 55 patients (males=25, females=30) with chronic heel pain for more than 6 months and failed conservative treatment. After proper clinical evaluation and diagnosis, autologous whole blood was injected on medial aspect of heel at the most tender point. Visual analog score was noted before injection and at 3 and 6 months of follow-up.

Results: Mean preprocedure visual analog score was 8.2 (range=4-10), which reduced to a mean of 4.5 (range=0-9) at 3 month follow-up and 3.3 (range 0-9) at 6 month follow-up. The reduction in VAS score was statistically significant (p<0.001). No complications occurred in our series.

Conclusions: Autologous whole blood injections appear to be cost-effective for treatment of resistant plantar fasciitis with no serious side effects. 
Intraoperative mobilisation of knee and its effect on the final functional outcome in patella fractures: a clinical study
Authors: Aher Deepak , Dandotiya Ajay , Raghuvanshi Dharmendra , Pathak Abhishek
Published: June 2018

Background: Treatment of patellar fractures depends on its type, integrity of extensor mechanism and fragments size. Operative measures are tension band wiring and partial or total patellectomy. Early weight bearing and then gradual mobilization and finally quadriceps strengthening remains the crux of physiotherapy. Aim of this study was to see for the effect of intraoperative mobilisation of knee on functional outcome of tension band wiring in patella fractures.

Methods: 30 patients were included in this study from January 2016 to February 2018. Tension band wiring was performed in all the patients. Intraoperative mobilisation of knee as allowed was done when patient was under effect of anesthesia. Final functional outcome was assessed as per the modified knee-rating scale of the Hospital for Special Surgery and also range of motion noted. Patients were evaluated at 1 month, 2 month, 6 month and 12 months.

Results: Patients aged from 25-65 years with mean age of 40 years. 26 patients were male and 4 female. In 20 cases, Right knee was involved. All had trauma due to road traffic accident. Mean operation time was 1 hour. At the end of 1 year follow up only 2 patients had range of motion <90, 4 patients had range of motion 90-120 degrees and 24 patients had range of motion >120 degrees. After 1 year, functional outcome was, excellent in 24, good in 4, fair in 1 and poor in 1.

Conclusions: Intraoperative mobilisation of knee after a stable fixation with tension band wiring of patella can prove to a very effective method for increasing postoperative range of motion and improving functional outcome.
A prospective study of relationship between medial joint pain and mild knee osteoarthritis
Authors: Dadarya Brajesh , Sirsikar Ashish , Vidyarthi Ashok
Published: June 2018

Background: The relationship between joint pain and osteoarthritis is poorly understood, however, the most common patterns associated with knee osteoarthritis are diffuse or medial joint pain. The objective of the study was to test the sensitivity of medial knee joint pain for the diagnosis of mild knee osteoarthritis, and thence its relationship.

Methods: This is a prospective analytical study of 124 patients visiting to our out-patient setup in the year 2017, with complaint of medial knee joint pain, which after thorough clinical examination, were investigated radiologically.

Results: In our study of 124 patients, there were 69 female (55.5%) and 55 male (47.5%), with a mean age of 59.3 years. The average duration of symptoms was 3.2 years, and the average VAS for severity of pain was 59.3. The sensitivity of medial knee joint pain for mild OA was thus calculated to be 79.8%.

Conclusions: Medial knee joint pain is a very important symptom to raise a suspicion and also to warrant further radiological investigation for the early diagnosis and management of knee OA.
Functional outcome of JESS fixation and bone grafting in distal tibial plafond-pilon fracture: a prospective study
Authors: Varghese Reji , Samuel Shajimon
Published: June 2018

Background: The Pilon fractures are one of the most difficult to treat. Fracture known as “orthopedicians nightmare”. The incidence of complications following ORIF of pilon ranges from 10-55% and other complication are infection, loss of reduction, secondary arthrosis. In these circumstances JESS and Bone grafting is cost effective and less hospitalization. Our aim was to evaluate in the functional outcome of JESS fixation and bone grafting in distal tibial plafond- pilon fracture using Olerud and Molander score.

Methods: The JESS fixation and bone grafting was used for pilon fracture in 30 patients, 24 male and 6 female. Mean age 44 years range (18-60 years). Fractures caused by fall and RTA. All were treated with JESS fixation and bone grafting. the patients were assessed clinically and radiographically at regular interval of 1 month and later 2 months interval. Outcome was assessed using Olerud and Molander score. Complications were recorded.

Results: 12 patients had Ruedi and Allgower type II fracture and 18 patients had type III fracture. After 9 month of follow up midterm OMAS score- 11.766 was achieved. Outcomes were good in 71.25% and fair results in 50.83% respectively. The complication seen was residual ankle pain in 6.66% patients and implant failure in 13.33%.

Conclusions: Fixation of pilon fracture with JESS and bone grafting is associated with good functional outcome in type II and fair in type III pilon fracture. The incidence of complications high in type III pilon fracture. 
A study on management of neglected shaft femur fractures by open intramedullary nailing
Authors: Jan Wazir Fahad , Jahan Alamgir , Dar Mohd Yahya , Bangaroo Firdous Ahmad , Khan Imran
Published: June 2018

Background: Fracture shaft of femur is a common and major musculoskeletal injury and in most of the cases the patients are immediately brought to hospitals for specialist orthopaedic management. However, it is not uncommon in developing countries especially in rural India for these injuries to be neglected initially due to the wide spred practice of quackery. The purpose of this study was to evaluate the effectiveness of open intramedullary nailing in the management of neglected fracture shaft femur patients in relation to achievement of union and functional results.

Methods: This was a prospective observational study conducted on 20 patients presenting to the Orthopaedic OPD of SHKM Government Medical College Hospital, Nalhar, Nuh, Haryana between August 2013 and December 2016, with a diagnosis of neglected fracture shaft of femur. All the patients underwent single stage open reduction and internal fixation with interlocking intramedullary nails. The patients were followed up for a period of 1 year. The patients were analysed for union and functional results.

Results: All the fractures united and the average time of union was 22.6 weeks. The average range of motion of the knees improved from 34 degrees in the preoperative period to 114.5 degrees in the postoperative period.  Two patients developed superficial infections at the incision site which resolved with local drainage and oral antibiotics. All the patients were able to return to their preinjury occupation.

Conclusions: Thus results of our study demonstrate that single stage open intramedullary nailing is a safe and effective surgical procedure for the treatment of neglected fractures of shaft of femur. 
Randomized controlled study comparing clinical outcomes after injection botulinum toxin type A versus corticosteroids in chronic plantar fasciitis
Authors: Samant Prakash D. , Kale Sachin Y. , Ahmed Sohrab , Asif Adnan , Fefar Mahendra , Singh Shikhar D.
Published: June 2018

Background: The plantar fascia is a common condition, for which there is no consensus on the best treatment option. The aim of this study is to compare the pain and fascia thickness outcomes of patients treated with botulinum toxin A injection versus corticosteroids injection.

Methods: 50 patients of plantar fasciitis randomly received injections of either botulinum toxin A (100 units in 2.5 ml normal saline) or methylprednisolone (2 ml of 40 mg/ml) under ultrasonographic guidance. Patients were assessed for pain using the visual analogue scale (VAS) and fascia thickness at baseline, 1 and 3 week, 3, 6 and 12 months post injection. Patients in the two treatment groups were compared for pain scores and thickness at each follow up.

Results: There were no significant differences in the patients in both the groups at baseline. Patients in both the groups had significant improvement in VAS pain scores over a 12 months follow- up. At the end of the study (12 month follow up), the VAS pain score was significantly lower in the group of patients who received botulinum toxin A (1.68±0.62 vs. 4.72±1.02, p value=0.001). There was a significantly less plantar fascia thickness in the group of patients who received botulinum toxin as compared to those who received corticosteroids at the 3 week, 3 month, 6 month and 1 year follow up.

Conclusions: Better clinical outcomes were observed with botulinum toxin type A as compared to corticosteroids. Similar studies need to be replicated with larger sample sizes before this can be offered as a standard treatment for plantar fasciitis patients.
Short term analysis of the functional outcome in complex primary hip arthroplasty
Authors: Ravi M. , Raja K. S.
Published: June 2018

Background: Total hip arthroplasty is the most commonly performed reconstructive procedure that replaces the femoral head, neck and acetabular articular surface. THA is a highly successful procedure that has made numerous patients return to excellent function without pain and provides a stable, pain-free mobile joint. The purpose of this study is short term analysis (retrospective and prospective study) of the functional outcome in 30 patients who underwent complex primary hip arthroplasty.

Methods: A retrospective and prospective study was done to evaluate the functional outcome in 30 patients who underwent complex primary total hip replacement and to analyze the results. A detailed clinical examination and radiological assessment was done to assess the nature of deformity, bone stock, functional impairment and component sizes. Pre-operative templating is routinely done in all cases. Pre-operative clinical evaluation was done using modified Harris hip scoring.

Results: Most of the patient was operated by Hardinge lateral approach (22 Patients). 8 patients were operated by Posterior Southern-Moore approach. In our study the average surgical time delay was 6 days ranging from 5 to 17 days. The average surgical time was 120 minutes ranging from 60 minutes to 3 hours.

Conclusions: The surgical technique employed is unique to each complex case. Surgeon expertise is also a must to deal with complex hips. Complex primary THA is an emerging trend with better clinical and functional outcome with the presently available modular implants and improved surgical techniques. 
Digital acrometastase as a primary manifestation of a bronchial adenocarcinoma
Authors: Rhounimi Mounir , Azirar Amine , Kharmaz Mohamed , Lamrani My Omar , Ouadghiri Mohamed , Bardouni Ahmed E. L. , Mahfoud Moustapha , Berrada Mohamed Saleh , El Kassimi Ilyas
Published: June 2018

Bone metastases of the hands and feet (acrometastases) are rare. Their presentation is variable and is generally confused with certain inflammatory conditions such as rheumatoid arthritis, gout, tenosynovitis, fracture or infection (panartius, osteomyelitis). The etiology of non-digital acrometastases is common to primary tumors with bone metastases (prostate, lung, kidney, breast, thyroid, and digestive tube). However, digital acrometastases are seen almost exclusively during bronchial neoplasia. We describe the case of a 43 year-old man admitted for pain and swelling of the middle finger distal phalanx of the left hand. Etiological assessement was in favor of an unusual secondary localization of bronchial adenocarcinoma. Tumoral causes must always be evoked before any inflammatory digital symptomatology, from where the interest of a good interrogation and a targeted paraclinical assessment. 
The relationship between atrial natriuretic peptide and microvascular complications of diabetes
Authors: KARAKAYA Pınar , ÖZDEMİR Bahar , MERT Meral , KOÇOĞLU Hakan , KUMBASAR Abdulbaki
Published: June 2018

Objective: In this study, we aimed to determine the relationship between the atrial
natriuretic peptide and microvascular complications of diabetes. Methods: Sixty patients with type 2 diabetes mellitus were enrolled into the study.
Patients with a chronic disease other than diabetes mellitus were excluded from
the study. The body-mass index, waist circumference, and hip circumference were
measured and blood samples for routine biochemical tests were taken after at
least 12 hours fasting. The microvascular complications of the patients were
evaluated. Results: Thirty-two of the patients had microvascular complications
whereas 28 of them did not. Age, body mass index, waist and hip circumference,
and atrial natriuretic peptide levels were significantly higher in the group
with microvascular complications than those without complications. There was no
significant difference in parameters like; waist-hip ratio, blood glucose,
HbA1c, fasting insulin, fasting HOMA, sodium, potassium, magnesium, calcium and
lipid levels between the two groups. When the relationship between atrial
natriuretic peptide and obesity, retinopathy, neuropathy, nephropathy, duration
of diabetes, HbA1c, and sex are evaluated separately, the only significant
parameters related to atrial natriuretic peptide were the body-mass index,
waist circumference, hip circumference measurements, and neuropathy. Conclusions: Positive correlations between serum atrial natriuretic peptide levels and
body-mass index, waist circumference, and hip circumference measurements were
determined. Also, serum atrial natriuretic peptide levels were significantly
higher in patients with obesity or neuropathy than those without obesity or
neuropathy.
SOSYAL BOT ALGILAMA TEKNİKLERİ VE ARAŞTIRMA YÖNLERİ ÜZERİNE BİR İNCELEME
Authors: Karataş Arzum , Şahin Serap
Published: June 2018

Facebook, Twitter, LinkedIn gibi çevrimiçi sosyal
ağların (OSN) popülerliği ve web servislerinin yaygınlığı, bu alanlarda sosyal
bot olarak nitelendirdiğimiz yazılımsal sosyal aktörlerin ortaya çıkmasına ve
yaygınlaşmasına neden oldu. Ancak çoğunlukla bu aktörler kötü rollerde
karşımıza çıkmaktadırlar.  Örneğin,
sosyal botlar insanmış gibi sohbetlere katılma, başka hesapları çalarak
üzerinden dolandırıcılık yapma, yanlış bilgi yayma, borsayı manipüle etme,
sahte halk tabakası oluşturarak propaganda yapma gibi ciddi problemlerde
karşımıza çıkmaktadırlar. Bununla beraber, istenmeyen postaları ve zararlı
yazılımları yaymanın en etkin araçları haline gelmişlerdir. Dahası, botlar
gerçek hesapları ele geçirerek “zombi bilgisayar ağı” (botnet attack)
saldırıları düzenlemekte de kullanılabiliyorlar. Öte yandan, sosyal botların
sosyal paylaşım ağları üzerindeki yaygınlığı ve önemi inkâr edilemez bir
gerçektir. Bu çalışmada, kötü niyetli sosyal botların potansiyel tehlikeleri
vurgulanmıştır. Sonrasında, metodolojik bir sınıflandırma içerisinde
literatürdeki bot tespit yaklaşımları, bu yaklaşımların sınırları ve açık
problemleri gözden geçirilmiştir. Makalenin son bölümünde, problemi çözmeye
yönelik iki yeni yaklaşım önerilmiştir.
BITCOIN'DE MAHREMİYETİ SAĞLAMA YÖNTEMLERİ
Authors: KARDAŞ Süleyman , KİRAZ Mehmet
Published: June 2018

Bitcoin, para transfer işlemlerini blokzincir olarak adlandırılan
dağıtık, halka açık ve sadece eklenebilir bir deftere kaydeden yaygın bir
kripto para birimidir. Bitcoin'in güvenliği, madenci ağ düğümleri tarafından
çalıştırılan teşvik uyumlu emek kanıtı tabanlı dağıtık uzlaşma protokolüne
dayanır. Kazanç karşılığında, madencilerin ağdaki sorumluluklarını yerine
getirmeleri beklenir. Öte yandan, 2009 yılında piyasaya sürüldüğünden beri,
Bitcoin ekonomisi çok büyük bir hızla büyümektedir ve şu anda pazar değeri 130
milyar dolara ulaşmıştır. Pazar ekonomisinin bu kadar yüksek olması, kişi ve
kurumların mahremiyetinin sağlanabilmesi için transfer işlemlerinin anonim bir
şekilde gerçekleşmesi istenir. Mevcut durumda Bitcoin'inin özü ile yapılan
işlemlerin takip edilebilmesi mümkün olmaktadır. Transferlerde gönderici/alıcı
ve işlem miktarlarının herkes tarafından görülebilmesi mahremiyet problemini
ortaya çıkarmaktadır. Transfer işlemlerinin anonim hale getirilmesi için pek
çok farklı yöntem geliştirilmiştir. Bu makalede, öncelikle Bitcoin’in ana
bileşenlerine genel bir bakış sunulmuş ve sistemdeki işlevselliği ile beraber etkileşimleri
açıklanmıştır. Daha sonra, Bitcoin'in mevcut anonimlik değerlendirmeleri sunulmuş,
var olan çözümlerin analizi ve olası güvenlik tehditleri ne yer verilmiştir.
Son olarak, sonuçlar değerlendirilmiştir.
简议公路工程施工安全风险的控制
Authors: 高 林虹
Published: June 2018

随着城市化建设的不断推进,促进了公路交通工程建设的发展,使得公路工程项目建设的数量和规模不断上升,同时其施工安全风险控制也变得日趋重要,基于此,本文简述了公路工程施工安全管理的主要特征,对影响公路工程施工安全的主要因素及其策略进行了探讨分析,并论述分析了公路工程施工安全风险控制。
探析高层建筑幕墙工程施工的技术要点及其质量控制
Authors: 农 骏磊
Published: June 2018

高层建筑幕墙不仅能够有效提升建筑主体的美观性,还能够有效提升其安全性。目前幕墙在现代高层建筑工程室外装饰中的应用十分广泛,为了充分发挥其作用,本文阐述了高层建筑幕墙工程施工的主要特征,对高层建筑幕墙工程施工的技术要点及其质量控制进行了探讨分析。
公路工程路基路面压实施工技术措施分析
Authors: 陈 念东
Published: June 2018

近几年,国民经济增长迅速,有效提升了人们的生活水平,在一定程度上增加了汽车的使用率。而公路工程是确保民众出行安全的重要条件,其路面工程的施工质量会对整个公路工程的安全性及稳定性造成巨大的影响,其中路基路面部分的压实施工更是确保工程质量的关键,如果不能对压实施工技术进行有效的应用,非常容易在压实施工中埋下质量隐患,导致公路的路基路面出现各种各样的问题,影响工程的总体质量,甚至影响公路的使用安全,基于此,文章围绕公路路基路面部分的压实施工技术进行讨论,了解影响该项技术效果的因素,并对其进行具体的探讨。
简析房屋建筑基础工程的CFG桩施工及其质量控制
Authors: 蓝 宝山
Published: June 2018

房屋建筑基础工程质量直接关系到建筑工程安全和稳定,并且其属于地下隐蔽工程,处理比较困难,而且其合理处理对于建筑工程项目建设的顺利实施非常重要,因此为了保障建筑工程的安全性,本文阐述了房屋建筑基础工程建设存在的主要问题以及CFG 桩的主要作用,对房屋建筑基础工程建设的CFG 桩施工要点及其质量控制进行了简要分析,旨在保障房屋建筑工程建设的顺利实施。
浅析建筑工程招投标阶段的造价控制
Authors: 唐 秋香
Published: June 2018

建筑工程招投标阶段造价控制是为建筑工程设计提供合理、准确的项目工程预算,以便确定投资规模,合理安排资金,并确保预算不超概算,并且是工程施工阶段工程造价控制的依据。因此如何对工程项目招投标阶段的造价进行有效控制,关系着整个工程项目的建设周期的缩短,工程质量的提高,建设资金的节约及投资效益的提高。基于此,本文简述了建筑工程招投标阶段造价控制的重要性,对建筑工程招投标阶段造价控制存在的问题及其措施进行了探讨分析。
影响建筑工程造价的因素及对策分析
Authors: 刘 晓霞
Published: June 2018

最近几年,我国建筑工程的数量不断增多,规模不断扩大,我国建筑行业在日常发展中也出现了较大的发展机遇。现如今,建筑行业内部的竞争日益白热化,因此建筑企业若要获得更大的竞争优势,就必须要采取有效措施做好建筑工程造价管理与控制工作。本文主要分析了建筑工程造价的影响因素及有效对策,希望以此促进行业发展,不足之处,望同行斧正。
浅析建筑工程造价的预算编制及其审核
Authors: 黄 世翔
Published: June 2018

建筑工程建设不仅需要做好工程造价的预算编制工作,还应加大预算审核力度,为确保工程造价的合理性奠定基础。基于此,本文阐述了建筑工程造价预算的编制准备,对建筑工程造价的预算编制要点及其审核进行了探讨分析。
建筑工程造价管理的困境及解决途径
Authors: 江 燕华
Published: June 2018

近年来,建筑行业的迅猛发展,使其行业内部竞争激烈程度逐渐提升,建筑企业也在不断通过加强管理、完善技术水平提升自身的综合竞争实力,而建筑工程造价管理是建筑工程管理的重要内容,其能够为建筑行业抢占市场先机提供坚实的基础；同时通过工程造价管理,实现成本控制,减少建筑企业的成本支出,保障自身经济利益的最大化。为此,为了保障建筑的持续、稳定发展,文章对建筑工程造价管理的困境进行了具体的分析,并探究了有效的解决方法,为建筑企业在激烈市场竞争中实现长足发展提供有力支持。
岩土工程勘察土工试验中的常见问题及改善方法
Authors: 吴 彤
Published: June 2018

在建筑工程领域,岩土工程勘察方面的土工试验对整个工程的设计来说具有至关重要的作用,该项工作的质量会对工程设计质量造成直接的影响,因此,本文围绕岩土工程勘察土工试验进行讨论,了解该项工作中的常见问题,并对改善问题的方法进行具体论述。
土建工程项目的施工进度管理与控制综述
Authors: 赵 松涛
Published: June 2018

由于土建工程涉及范围广,所需要管理的内容多,而面对众多的管理内容,就会使建筑企业忽略对土建工程的进度管理工作,导致土建工程施工进度被延长。因此,土建工程需要加强进度管理工作,本文就对土建工程项目施工进度管理的重要意义进行阐述,并提出做好进度管理工作的对策,以期为土建工程管理工作提供参考依据。
基于房屋建筑工程现场管理优化方案探究
Authors: 邓 维
Published: June 2018

我国城市化建设的加快和经济的发展,推动了建筑行业快速发展。为确保建筑工程施工的顺利展开和建筑质量达标,就需要不断加强工程施工现场管理。本文结合当前建筑工程现场管理的实际,对建筑工程施工现场管理存在的主要问题进行了分析,研究探讨了优化建筑工程施工现场管理的对策措施,希望能给广大同行提供参考借鉴。
市政工程项目管理存在的问题及对策分析
Authors: 邓 志强
Published: June 2018

城市建设是我国目前重要的工作研究对象。为了实现更快、更好地城市化建设,需要针对城市市政工程采取有效的管理措施,以控制市政项目的运行状态符合社会的要求。市政工程项目组成部分众多,而我国的政府也正在全力加大投入,旨在创建更加美好的社会环境,然而,在实际的市政工程项目建设过程中仍然面临许多挑战。相关的管理控制手段无法达到预想效果,市政工程的工作状态和进步发展都出现了停滞现象。所以本文主要针对市政项目管理方面的不足之处着眼展开相关讨论,通过对问题的分析,之后有针对性地提出了几点改进市政工程项目管理的建议,希望可以帮助市政工程通过良好的管理措施,获得令人满意的工作成果。
浅析BIM在工程造价管理中的运用
Authors: 樊 慧
Published: June 2018

在科学技术不断创新与发展的今天,工程造价为实现信息化管理逐渐将BIM 技术引入进来,从而在一定程度上促使造价管理得到了有效地发展,并且促使我国建筑工程向现代化的趋势不断演变,使得工程造价管理得到了非常大的进步。为此,本文围绕BIM 在工程造价管理中的运用进行具体的论述,望能够促使我国工程造价管理水平得到显著性的提高。
道路桥梁工程项目管理与监理一体化服务模式实践
Authors: 赖 观松
Published: June 2018

道路桥梁工程项目是道路工程的重要组成部分, 其管理与监理一体化对于整个工程建设工作的顺畅有序的进行有着非常好的促进作用。本文对道路桥梁工程项目的管理与监理一体化进行了研究,并选取了一些方面进行了重点的分析,期望能为道路桥梁工程的项目管理与监理工作提供一些参考。
钢结构房屋建筑结构设计问题探讨
Authors: 邱 子清
Published: June 2018

在我国社会经济快速发展的今天,我国建筑行业的发展速度也是十分显著的,在此期间钢结构得到了较为广泛性的运用。在我国建筑性能日益多样化的基本现状下,人们对于钢结构的设计方面提出了更为严格的标准,并且,建筑结构设计过程中钢结构问题也逐渐凸显出来,对此,本文围绕钢结构房屋建筑结构设计问题开展具体的探究,望能够对同行业有一定的可参考价值。
园林景观树木的养护管理
Authors: 闫 培凤
Published: June 2018

园林景观树木是适用于城市园林绿地及风景区栽植应用的木本植物,包括各种乔木、灌木和木质藤本,其应根据不同地区的环境气候选择合适当地树木进行栽植,并且为了保障其正常成长,必须加强其栽植及其修剪养护管理。基于此,本文阐述了园林景观树木的主要作用,对园林景观树木栽植的养护管理与修剪养护管理进行了探讨分析。
浅探现代建筑中的景观设计
Authors: 吴 樱子
Published: June 2018

建筑景观设计是一门与时俱进的设计艺术，涉及建筑、景观、生态学、园林、艺术美学等多学科，在建筑景观设计的发展进程中，建筑景观设计师们要勇于正视存在的问题，并勤于归纳总结，这样才有利于发展和完善建筑景观设计，使之向着服务于人类社会、有利于建筑景观、自然环境、人类社会的和谐方向发展，同时促进建筑景观设计的可持续发展。建筑景观设计是一项非常重要的系统性研究领域所在，应当引起我们足够的重视。建筑设计和景观设计的共性和融入措施进行系统的论述分析。最后，结合自身多年工作研究经验，针对建筑景观设计开展措施问题。
浅谈城市污水管理设施建设
Authors: 袁 晓杰
Published: June 2018

污水处理的设施建设能够很好地解决当前水污染所所面临的问题,同时,这几年有实践证明了对于建设污水处理设施的研究有利于中国社会和经济的国情发展,越来越多的新型污水处理设施的建设正在日益成熟发展,然而,在该项研究的不断发展当中逐渐显露出许多问题,在这些问题的有些安排和制度方面,或者是在管理模式的方面必须要有所改造,设计和创新,从而进一步地完善和加强来适应我国的市场化建设需求。改革开放以来,我国在城市水污染防治工作方面成绩卓著,但严重的水污染趋势难以得到明显遏制和扭转,作者从我国中小城市污水处理的问题,探析中小城市污水处理建设的基本方向。
高层民用建筑结构抗震的优化设计
Authors: 米 莹
Published: June 2018

高层民用建筑工程不仅要满足人们的日常生活要求,还要注重保障自然灾害发生时的安全,提高抗震能力和质量水平。高层居民建筑具有垂直高度高、楼层多、居住人群多的特点,因此做好高层民用建筑结构抗震的优化设计具有重要的意义。高层民用建筑结构的抗震性、稳定性受到结构体系选择、场地选择、结构的规则性等多个因素的影响。本文结合高层民用建筑各方面的特点,研究了各个环节中增强其抗震性的结构设计,希望在以后的实际情况中能够对我国高层民用建筑抗震优化的相关实践有所帮助。
建筑工程造价管理问题与对策
Authors: 王 品
Published: June 2018

在建筑工程施工中,造价管理是非常重要的一个环节,同时造价管理的质量与水平也直接关系到了企业经济效益的实现,采取有效措施开展造价管理工作能够更好地控制建筑工程的建设成本。但是从当前的发展情况来看,我国建筑工程造价管理工作中还存在着明显的问题,因此,为了更好地提高建筑工程造价的合理性,就必须要采取有效措施加以改善。