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A case of tracheal stenosis following tracheostomy is reported. Evidence is presented that the lesion was caused by a red rubber tracheostomy tube. The anaesthetic technique used for resection of the trachea is described. It is suggested that rubber should be avoided for any intubation of the respiratory tract lasting more than a few hours.

The analgesic efect of morphine sulphate 10 mg by mouth given pre-operatively on pain after gynaecological laparoscopy was studied in a randomised, prospective, double-blind, placebo-controlled comparison. Two groups of 56 patients were studied, one group undergoing diagnostic laparoscopy and the other laparoscopic sterilisation. AN patients received a standard anaesthetic after premedication with morphine or placebo I h before the operation. Morphine premedication did not significantly influence postoperatice pain as assessed on a visual analogue scale in either group and posloperative opioid consumption was unaffected.Premedication with morphine 10 mg orally does not sign$cantly decrease pain after day-case gynaecological laparoscopy .

Case presentationFetal ovarian cysts were first described as a prenatal finding by Valenti et al. 1 in 1975 and were believed to be a rare finding. 1 With recent technologic advancements in prenatal sonography, fetal ovarian cysts have been detected more frequently. Ovarian and genital tract abnormalities constitute approximately 20% of all abdominal masses in the neonate.These cysts vary in size; they can be simple or complex, and are commonly unilateral. Intrauterine complications such as torsion and rupture may occur, and treatment options vary from conservative management to antenatal aspiration, early delivery and neonatal surgery. Nussbaum et al.3 thus categorized fetal ovarian cysts according to ultrasound criteria into two groups: simple (uncomplicated) and complicated. The sonographic features of uncomplicated cysts are anechogenic, round, >20 mm in diameter, unilocular, intrapelvic or more often intra-abdominal, unilateral or seldom bilateral, thin-walled, and more or less mobile with the mother's positions. Sonographic features of complicated cysts are heterogeneous with hyperechogenic components, thick-walled, containing free-floating material, with intracystic septations and mobile after adnexal torsion; the absence of color Doppler flow is 100% and therefore highly specific for torsion.We report a neonate with complicated congenital ovarian cyst and daughter sign who was diagnosed in utero.Case report A 4760 g female delivered via elective cesarean section for macrosomia with an estimated weight 5000 g to a 21-year-old gravida 3, para 1 mother. The baby's apgar scores were 8 and 9 at 1 and 5 min of life respectively. The baby was taken to the neonatal intensive care unit for further evaluation and observation. The maternal history was insignificant, blood type A-negative, rapid plasma reagin nonreactive, group B Streptococcus-negative, hepatitis B surface antigen-negative, and antibody screen-negative. Prenatal ultrasound (US) 1 week before delivery showed:A unilateral intra-abdominal cyst located slightly in the right lower quadrant, with thin septations, was detectedy Further evaluation confirmed female genitalia and normal-appearing fetal urinary and gastrointestinal (Figure 1).Physical examination on the first day of life was not remarkable, except for the presence of a mass in the right lower quadrant of the abdomen. This mass was described as being firm but not hard, with the consistency of a water-filled balloon, measuring 6 Â 3 cm, and was freely movable within the right lower quadrant.Abdominal X-rays revealed displacement of the small bowel to the left without evidence of mechanical obstruction (Figure 2). Formula was tolerated well and a transitional stool was passed. Surgical consultation was obtained, and the patient underwent two abdominal US (Figure 3) and magnetic resonance imaging (MRI) of the abdomen and pelvis which revealed right lower quadrant cyst with daughter's cyst sign. (Figure 4).Surgical exploration was performed. At the time of surgery, unilateral ovarian cyst measuri...