The objective of this study was to assess the value of dual X-ray absorptiometry (DXA) in comparison to non contrast computed tomography (NCCT) density as possible predictors of upper urinary tract stone disintegration by shock wave lithotripsy (SWL). This study included 100 consecutive patients, with solitary renal stone 0.5-2 cm or upper ureteral stone up to 1 cm. DXA to calculate stone mineral density (SMD) and stone mineral content (SMC) was done. NCCT was performed to measure Hounsfield units (HU). SWL was performed with an electromagnetic lithotripsy, plain X-ray documented disintegration after SWL. Successful treatment was defined as stone free or complete fragmentation after 1 or 2 sessions of SWL. The impact of patients age, sex, body mass index, stone laterality, location, volume, length, mean SMC and SMD, HU and Hounsfield density (HD), skin to stone distance (SSD) and number of shock waves were evaluated by univariate and multivariate analysis. Only 76 patients were available for follow-up. Success of disintegration was observed in 50 out of 76 patients (65.8 %). On multivariate analysis, SMC and number of shock wave were the significant independent factors affecting SWL outcome (p = 0.04 and p = 0.000, respectively). SMC as detected by DXA is a significant predictor of success of stone disintegration by SWL. SMC measured by DXA is more accurate than HU measured by CT. Patients with high stone mineral content (SMC greater than 0.65 g) should be directly offered another treatment option.

Background: Vertigo is an illusory sense of motion in the absence of real movement, either in the self or the environment. Vertigo is isolated and has no positive indications of dysfunction of the central neurological system. Study aims at studying MRI, TCD and BAEP relationships and alterations in individuals with isolated vertigo. Methods: Patient control research involves 50 patients with isolated vertigo, 50 matched age and gender health controls, from Al-Azhar University Hospitals, Assuit, Egypt, neurology and audio vestibular hospitals, from May 2019 through to June 2021. Results: patient start age with vertigo (40-60), disease duration (2-3) years, 70% with peripheral vertigo,30% with central vertigo, 86% with abnormal and 70% with abnormal BAEP and 74% with vertigo with an abnormal TCD. Relationship and variations in cervical MRI, TCD and BAEP in 50 patients with "isolated" vertigo and 50 healthy controls respectively were examined. Results: A statistically significant differences between the two groups were found for total TCD, BAEP abnormalities and no significant differences between the two groups in cervical MRI abnormalities. The findings revealed strong associations between TCD and cervical MRI, TCD and BAEP in the vertigo group. And TCD PI analysis and certain BAEP items revealed positive linear relationships. In the control group, there were no statistical differences or relationships. Conclusions: TCD is a "isolated" vertigo screening sensitive technique. A combined cervical MRI, TCD and BAEP test regimen is suited to evaluate the "isolated" vertigo.