Reply to the editor/reviewers:
Reviewer A:
1. Proofreading performed.
2. All patients received cemented fixed bearing implants. We have added the post-operative tibial-femoral angle to Table 1 as requested. It was comparable between the BMI groups (unlike age which was significantly different) and hence was not included in the multiple linear regression analysis.
3. The patients included in this study are only those with single medial compartmental osteoarthritis. Patients with pre-existing patellofemoral arthritis were excluded.
4. Statistical significance was defined as p-value <0.05
5. Added the detail of treatment for fracture UKA patients and the outcomes.
6. We have added a paragraph reporting the difference in pre-operative KSS knee score, OKS and SF-36 physical component score (comparing severely obese group to control, overweight and obese
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In our study, there were 6 medial tibial plateau fractures. Half was from the control group and the rest were one each from the overweight, obese and severely obese group. Hence, we could not correlate the relationship between BMI and UKA fracture.
Reviewer B:
1. Proofreading performed.
2. Agree with the small sample size of morbidly obese / superobese patients. It is the limitation of this study.
Reviewer C:
1. In our institution, the outcome scores were only measured at before surgery, 6 months and 2 years post-surgery. Due to multiple reasons, outcome scoring was not done beyond 2 years. The follow-ups after 2 years were mainly to see if patient develop any new complaints which to be addressed upon.
2. We have added the mean BMI recorded in each of the 4 BMI groups in Table 1 as advised by the reviewer.
3. The complication rate was 5 (2.2%), 10 (3.5%), 5 (4.0%) and 2 (6.7%) in the Control, Overweight, Obese and Severely Obese groups respectively (p=0.931). This was found throughout the follow-up period. Our study found comparable complication rate and improvement in functional outcome across the 4 BMI
After obtaining approval from our Institutional Ethics Committee, a prospective double-blind, randomized, controlled study was conducted in El-Minia University Hospital. Ninety patients of both sex undergoing lower extremities surgery their age ranging from 17- 60 years old, ASA physical status I or II. This study was done from December 2010 to December 2011. All patients gave written informed
The significance of her BMI is used for the estimation of weight that is associated with health and longevity. It is
Bone Mineral Density. Among the site(s) at danger for osteoporotic breaks, the bone site that is generally reliably appeared in studies to be connected with decreased bone mineral thickness (BMD) in DM1 is the hip. While a few exemptions exist [43], most studies show mediocre hip BMD among those with DM1 contrasted with controls without diabetes. In a meta-examination consolidating consequences of five studies, Vestergaard showed a huge diminishment in 푍 scores at the hip (푍score: −0.37±0.16, 푃 < 0.05) among patients with DM1 contrasted with controls. Discoveries from a case control study by Eller-Vainicher and others were comparable, where a diminishment in femoral neck BMD 푍 scores was seen among patients with DM1 (−0.32 ± 0.14) contrasted with controls (0.63 ± 1.0, 푃 < 0.0001) coordinated for age, BMI, and
Overweight is often misinterpreted as obesity, but it has been proven that individuals such as bodybuilders and professional athletes can be overweight yet they do not suffer from obesity. Obesity refers to just excessive body fat whereas overweight refers to excessive body weight including water, bone, fat, and muscle. A certain amount of fat is needed to store energy, heat insulation, shock absorption, and other functions, but when men reach more than twenty-five percent body fat, and women reach more than thirty percent they are considered obese. A person’s body mass index (BMI) is measured by dividing body weight in kilograms by the square of body height in meters (Wilmore, et al., 2008).
Obesity remains an extremely serious issue worldwide. Once considered a problem for wealthier counties, overweight and obesity are now dramatically increasing in low and middle income countries (WHO, 2011). In American, the rates of obesity continue to soar. CDC (2009) recognizes obesity as a risk factor for diabetes, heart disease, high blood pressure, and other health problems. According to NHANES over two-thirds of the US are overweight or obese, and over one-third are obese (CDC, 2009). Treatment for this illness varies; it may include the incorporation of diet, exercise, behavior modification, medication, and surgery. Since there is no single cause of all overweight and obesity, there is no single way to prevent or treat overweight
The pathophysiology of obesity is when there is a buildup of excess body fat. This excess body fat is determined by calculating a person body mass index (BMI). The BMI is calculated by an individual’s weight in kilograms divided by the square of a person’s height in metersthis allows us to come up with appropriate range of weight to an individual’s height. The body mass index is used to find out if an individual is overweight or obese. Individuals who’s BMI that have a range of 25 to 29.99 are thought to be pre- obese and overweight When an individual body mass index has surpassed 30kg this person is considered obese. As an individual’sBMI increases they become part of a different class of obesity there’s class I which is 30-34.9, class II
In order to identify a condition as a disease, it should fit certain criteria. One of the reasons that obesity is classified as a disease is because of its large comorbidity. Obesity is a risk factor for chronic diseases such as hypertension, dyslipidaemia, type 2 diabetes, cardiovascular disease, sleep apnoea, musculoskeletal disorders and some cancers (Rossner, 2002). According to Rossner (2002), the death rate from all causes, cardiovascular disease, cancer and other diseases increases among moderate and severe overweight men and women in all age groups. Therefore, obesity is
(43) (ii) Peripheral DEXA devices are cheaper portable instruments using the same technology as DEXA but they measure BMD at peripheral sites, such as the forearm, calcaneus, or finger. However, there are limitations of these devices in evaluating fracture risk prediction due to technical differences, variation in the definitions of the bone regions of interest measured, and lack of standardized reference databases for calculating T-scores. However, low T-score values at peripheral sites measured by peripheral DEXA devices are found to be associated with increased fracture risk. (38)
Obesity should not be an unknown term to the majority of the Americans as a significant percentage of the American population is obese. As the number of obese people skyrockets annually, obesity tends to be a major threat not just in America, but globally. The number of obese individuals has doubled in past four decades, probably by practicing the art of super-sizing (Marks). Obesity is a complex physical problem in which a person weighs 20% or more in addition to his normal body weight for given height and age and Body Mass Index (BMI) which includes those of 30 and
Grier, T., Canham-Chervak, M., Sharp, M., & Jones, B. H. (2015). Does body mass index
One factor that had not been investigated was whether the variables of QUS were as affected by clinical risk factors as axial BMD measurements obtained by using the DXA method. A study was conducted to compare the calcaneal QUS and axial BMD T and Z scores in a large group of women (specifically 1115 pre- and postmenopausal women). Some of these women had no clinical risk factors whilst others had one or more risk factors for osteoporosis. (Frost, M. L., Blake, G. M., & Fogelman, I. (2001)). They investigated measurements at the calcaneus using QUS and at the lumbar spine and hip using DXA and found that the variable of QUS were affected to the same extent as axial BMD measurements using the DXA method. This important finding could become critical in the standardisation of QUS in clinical practice.
I believe this due to the numbers that were produced in the “difference” column of the spreadsheet. In this column the numbers come from taking BMI and subtracting % Fat BIA . Based on what the numbers were in each of these columns could result in a negative or positive number which means that the results are both overestimated and underestimated; if the number is negative then the results or underestimated. These negative numbers could come from a wide variety of circumstances from an incorrect measurement of BMI. First off, BMI measurements cannot decipher between the different types of fat in a person or the location. The location of fat is key in terms of increased risk of disease. For example, a person may have a lower BMI than someone else who appears healthier but if the person with a lower BMI has a majority of their fat stored in their belly they are at higher risk for disease than a person who has fat distributed elsewhere. The fat in the belly displays a higher risk for disease due to the fact that it will release compounds that can commence disease (Cespedes). Fat located on the hips, thighs, etc. are healthy in a proper amount and do not result in such dramatic increases as fat in the belly
The S-weight and P-weight study was done on 556 university students as well as 167 overweight and obese patients that were part of a hospital weight management program. The DBI study was done on 264 college students and in a large sample of adolescents who were enrolled in a fat reduction program.
Obesity rates are soaring throughout North America (What Is Obesity?, 2013). With obesity reaching almost epidemic proportions in the United States, and the threat of a global epidemic, we must watch this alarming increase carefully ( Health Risks of Obesity, 2013). Obesity is defined as: "…an excess of adipose tissue…" (A Report of the Surgeon General, 2014). The two most common measures of obesity are Body Mass Index (BMI is a ratio of weight to height) and relative weight index, such as percent desirable weight (Body Mass Index , 2013). BMI is the most frequently used measure of obesity as it has a strong correlation with more direct measures of adiposity, such as underwater weighing (A Report of the Surgeon General, 2013). Some
Source: CDC, National Center for Health Statistics, National Health and Nutrition Examination Survey. Health, United States, 2002. Flegal et. al. JAMA. 2002;288:1723-7. NIH, National Heart, Lung, and Blood Institute, Clinical Guidelines on the Identification, Evaluation and Treatment of Overweight and Obesity in Adults, 1998.