We report the management of a patient who suffers from narcolepsy and cataplexy and presented to the clinic at 14 weeks of gestation. Her symptoms were resistant to modafinil but controlled with clomipramine and amphetamine. Discussion concerning mode of delivery for these patients is scarce in the literature. We discuss some issues surrounding the antenatal management and counselling regarding mode of delivery and postpartum care.

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Rectal prolapse is protrusion of some or all layers of wall of rectum. In infants, the prolapse usually involves all layers of wall of rectum called as complete prolapse or Procidentia. In children its incidence is higher during first year of life. It has several causes such as constipation, diarrhoea, malnutrition, muscular weakness, worm infestation etc. but mostly it occurs due to straining associated with chronic constipation. Usually it is a self-limiting entity most of which resolves spontaneously within 1 year of life. It is managed by dietary modification, toilet training along with some sort of conservative treatment but sometimes it may require surgical treatment. In Ayurveda, it is described as Gudabhranshaand caused by excessive straining anddiarrhoea. There are several treatments available in Ayurveda which can help in early resolution of disease or reduce the chances of having surgery for correction. In this review article we assess the various treatment modalities available in Ayurveda along with contemporary medical science which can be used in the better management of Rectal Prolapse.