Background: Cephalopelvic disproportion (CPD) is associated with significant maternal and fetal morbidity and mortality in developing countries. CPD complicates 2-15% of pregnancies. This study aimed to determine the diagnostic accuracy of sacral rhomboid dimensions in the prediction of CPD in primigravidaeMethods: This prospective study was conducted on 400 primigravidae at 37-week gestation in Department of Obstetrics and Gynaecology at Lady Hardinge Medical College, New Delhi. Women with height>145 cm were subjected to measurement of transverse and vertical diagonals (TD and VD) of sacral rhomboid prior to delivery. Following delivery, the women were divided in two groups: control group (normal delivery, n=290) and study group (caesarean section for CPD, n=56). The sacral rhomboid dimensions were compared in both the groups and statistically analysed.  Results: The mean maternal height in both the groups showed no significant difference (156.88±5.7 vs 155.02±4.75, p=0.011). However, in univariate analysis, maternal height of≤154.5 cm, VD ≤10.25 cm and TD≤9.75 cm showed a diagnostic accuracy of 58.3%, 55.4% and 78%, respectively. Of all the parameters, TD≤9.75 cm was the most significant factor in predicting CPD (34% vs 13%), OR 3.3 (95%CI: 1.7- 6.7, p<0.001).Conclusions: A simple measurement of transverse diameter of sacral rhomboid is a better predictor of CPD in an average height Indian primigravidae. It can be used in community hospital to detect high risk primigravidae.

Obesity is a global public health problem because of its increased prevalence and health effects. It is the most common disorder encountered in clinical practice, which has serious social and psychological dimensions that affect all age groups. A 28-year old married obese male whose body weight and height were 97 kilograms and 5.9 feet respectively showed a body mass index (BMI) of 30. All the examinations and tests were normal before the study. There were 3 weight reduction regimes that included only walking in the morning during the first month, followed by walking with dieting in the second month and in addition to dieting and walking, two tablets of Navaka Guggulu was prescribed to be taken daily. The vital signs, bowel habits, micturition habits and appetite were assessed daily. After the interventions, the weight reduction was observed at 0.5, 0.8 and 4.7 kgs at the end of the first, second and fourth month, respectively. The results of routine blood parameters, autonomic function tests and respiratory function tests were normal with an increase in the haemoglobin level, high-density lipids and a decrease in the total cholesterol level, triglycerides, low-density lipids and very low-density lipids. The present study showed that Navaka Guggulu was not only beneficial but also safe and efficacious in the treatment of obesity.

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