Jaundice is a common problem in society, it is important to discriminate between obstructive and non obstructive cause due to high morbidity in cases of obstructive jaundice, also non obstructive jaundice requires medical management while obstructive jaundice requires surgical intervention. Our study was done with aims to determine role of MRCP in cases of obstructive jaundice in correlation with ultrasonography keeping post surgical follow ups/ ERCP/ histopathology as gold standard for final diagnosis. All patients in our study undergone USG followed by MRCP. We had included total 100 patients out of which 58 females and 42 males. Out of all patients we have observed 56 malignant causes and 44 benign causes. We have observed benign conditions are seen more frequently in adults while increase in frequency of malignancy with increase in age thus there found to have direct relationship of malignant etiology with increase in age. Most common benign cause observed in our study was choledocholithiasis while most common malignancy was carcinoma head of pancreas. In our study we have concluded that MRCP is better modality with high sensitivity, specificity and diagnostic accuracy as compared to USG also with use of MRCP invasive procedures like ERCP can be avoided just for diagnostic purpose. We have also noticed few limitations of both USG and MRCP in process of diagnosis.

Objectives To assess the use of proximal protection devices in consecutive patients as the preferred means of cerebral embolic protection for primary carotid stenting. Methods and Results This was a prospective single-center study to evaluate the technical and clinical success of proximal protection devices as the first choice for embolic protection in symptomatic (≥ 50%) and asymptomatic (≥ 70%) carotid stenosis. Proximal protection devices were used for embolic protection in 115 consecutive patients. No patients were excluded for anatomical reasons. The filter used was of diameters 6 mm in all cases (Emboshield NAV filter device, Abbotts Healthcare Pvt. Ltd. [Lake Bluff, Il]). In all cases, self-expanding closed-cell designed stent was used (X-act closed-cell self-expanding nitinol carotid-tapered stent, Abbotts Healthcare Pvt. Ltd.). Plaque characterization was done by using real-time high-resolution ultrasound (HR USG) equipment (Aloka Prosound Alpha 7 [Chiyoda, Tokyo, Japan]) using high-frequency linear transducers (> 7 MHz). Follow-up duration was 30 days. Mean age was 61.9 ± 8.27 years. There was male predominance observed in study accounting for 73 out of total 115 studied population. Fifty-six of 115 (48.89%) treated stenoses were symptomatic. Technical success was achieved in 115 of 115 (100%) cases. In both the cases, additional distal filter devices were used. Carotid stenting was successful in 115 (100%) lesions. This study observed higher number of debris in symptomatic and high-risk plaques. This study also observed higher sensitivity, specificity, and accuracy of updated classification for assessing risk of microembolism (captured debris) (sensitivity 73.91%, specificity 95.65%, positive predictive value [PPV] 91.89%, negative predictive value [NPV] 84.62%, accuracy 86.95%). In our study, minor stroke was seen in three (2.61%) patients within 48 hours, and no adverse events were seen within 48 hours to 1 month. Conclusion Proximal protection is a safe method as the first choice for embolic protection. It can be used with a high rate of technical success.

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