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Our data suggest that off-pump CABG patients have the same late mortality, MACEs, and graft patency rates as conventional cardioplegic cardiac arrest CABG patients. In our opinion, urgent or emergency CABG for patients with STEMI can be done either way.

The mitral valve is a complex, dynamic and functional apparatus that can be altered by a wide range of disorders leading to stenosis or regurgitation. Surgical management of mitral valve disease may be difficult. Planned intervention may not always be feasible when the surgeon is faced with complex pathology that cannot be assessed fully by conventional 2D echocardiography. Transthoracic and transesophageal 3D echocardiography can provide a more reliable functional and anatomical assessment of the different valve components and evaluation of its geometry, which can aid the surgeon in planning a more suitable surgical intervention and improve outcomes. Although 3D echocardiography is a new technology, it has proven to be an important modality for the accurate assessment of valvular heart disease and in the future, it promises to be an essential part in the routine assessment of cardiovascular patients.

Tourniquet application has been widely accepted to improve survival for major limb trauma. Colour duplex ultrasound (US) can be used as a non-invasive method of confirming cessation of arterial flow. Participants with no or limited experience of ultrasound were taught to apply the Combat Application Tourniquet with ultrasound guidance. Following this, participants were tested in effective tourniquet application: Blind and with ultrasound guidance. US guidance improved abolition of limb perfusion from 22 to 93 per cent in upper limb; from 25 to 100 per cent in lower limb (p=0.0027 and <0.0001). No significant difference was found in application time for the lower limb; less time was taken for application with US guidance in the upper limb 8.1 (7.1, 8.6) vs 4.5 s (4.0, 5.3; median (IQR)), p=0.002. Tourniquet ultrasound skills are rapidly acquired by novice operators. Accuracy improves with ultrasound guidance, this may have a role in improving survival.

Developing fetus is connected to the mother by placenta to receive oxygen and nutrients. Maternal exposure to ambient air pollution not only affects maternal health but also provides a pathway for many toxic pollutants to cross the placental barrier and interrupt biochemical milieu. There are numerous scientific studies available describing possible negative health impact of air pollutants on reproductive health, pregnancy outcomes and fetal development yet no toxic effect is available recently. Studying the pollutants exposure effect on fetal development is crucial for the underlying mechanism between prenatal exposure and pregnancy outcomes. Present review meticulously provides the compiled data of 40 most recent studies with possible action mechanism of air pollutants on pregnancy outcomes and fetal development to find a better solution to exterminate or reduce the problem.