White Deposits Research Articles

Detection of Hard Exudates in Retinopathy Images

The tissue layer located at the back of the eye is known as retina which converts the incoming light into nerve signals and those signals are sent to the brain for understanding. The damage onto the retina is termed as retinopathy and that may lead to vision weakening or vision loss. The hard exudates are small white or yellowish white deposits with their edges being clear and sharp. In the proposed methods we take color image of retina then extract the green channel of that image then apply top hat transformation and bottom hat transformation on that image. The DIARETDB1 and High-Resolution Fundus (HRF) databases are used for performance evaluation of the proposed method. The proposed technique achieves accuracy 97%, sensitivity 95%, and specificity 96% and it takes average 5.6135 second for detection of hard exudates in an image.

Sharma's parachute sign a new laparoscopic sign in abdomino pelvic tuberculosis

AimsTo demonstrate a new laparoscopic sign “Sharma's Parachute sign” in abdominopelvic tuberculosis in women with infertility. MethodsA total of 104 women who were diagnosed to have abdominopelvic tuberculosis, on endometrial sampling or on laparoscopy were enrolled in this ongoing study on tuberculosis in infertility. A new laparoscopic “Sharma's parachute sign” was looked for in these cases on laparoscopy. ResultsThe mean age, pairty and duration of infertility was 27.6 years, 0.58 and 4.1 years respectively. Menstrual dysfuction were common especially hypomenorrhoea (34.61%), oligomenorrhoea (36.53%) along with constitutional symptoms and abdomino pelvic pain or lump. Diagnosis of abdominopelvic tuberculosis was made by identification of acid fast bacilli (AFB) on microscopy or culture of endometrial aspirate or peritoneal biopsy or positive gene Xpert or positive polymerase chain reaction (PCR) or histopathological demonstration of epithelioid granuloma on endometrial or peritoneal biopsy, various laparoscopic findings on pelvic and abdominal organs were tubercles and shaggy areas (white deposits, caseous nodules encysted ascites, abdominal and pelvic adhesions, tubal findings (hydrosalpinx, pyosalpinx, beaded or calcified tubes). A new “Sharma's parachute sign”in which ascending colon was totally adherent to anterior abdominal wall with its mesocolon looking like an open parachute with small caseous nodule was seen in 11 (10.5%) cases. ConclusionDiagnostic laparoscopy is an important investigation for abdominopelvic tuberculosis showing various adhesions including new parachute sign.

A Two-Year Outcome of Intrastromal Corneal Ring Segment Implantation in Keratoconus: Initial Report in Thai Patients

Objective: To determine two-year outcome of intrastromal corneal ring segment (ICRS) implantation in keratoconus in Thai patients Methods: A retrospective review of medical records of the patients underwent Ferrara-type ICRS implantation (single and two segments) at Siriraj Hospital between November 2013 and December 2017 was conducted. Clinical outcomes were assessed at 1 month, 6 months, 1 year, and 2 years postoperatively. Results: Of 9 eyes in 8 patients, the mean age of the patients was 24.6 ± 7.5 years. The mean follow-up time was 32.2 ± 9.4 months. Overall, the median visual acuity was significantly improved postoperatively (p value = 0.007). At 2 years, the uncorrected visual acuity (UCVA) improved from 1.00 logMAR to 0.56 logMAR, and the corrected distance visual acuity (CDVA) improved from 0.76 logMAR to 0.10 logMAR. Correspondingly, the median spherical equivalent refraction was significantly improved postoperatively from -7.38 D to -3.13 D (p < 0.001). Moreover, the median anterior corneal topographic data significantly changed between visits (p < 0.02). The Kmax decreased from 52.65 D to 46.65 D and the Kmean decreased from 48.10 D to 45.40 D at 2 years. Postoperative adverse effects were glare and halos (3 eyes), visually insignificant small white corneal deposits around the segments (2 eyes), extrusion of a ring segment needed removal with reversible to baseline vision (1 eye). Conclusion: This initial report in Thai patients showed that the ICRS implantation in keratoconus could improve the visual, refractive, and topographic parameters with stability at 2 years. However, appropriate case selection and surgical technique should be considered.

Managing siloxanes in biogas-to-energy facilities: Economic comparison of pre- vs post-combustion practices

Siloxanes present in small concentrations in biogas interfere with the operation of biogas-to-energy facilities. During biogas combustion, siloxanes form white deposits on engine components (engine heads, spark plugs, valves) in crystals or amorphous forms depending on the temperature. The purpose of this study was to evaluate the economic feasibility of biogas-to-energy systems for managing the operational challenges due to siloxanes in biogas. The facility maintenance cost data were compiled by a survey of biogas-to-energy facilities in the United States. Economic analyses were performed to compare the operational costs due to increased maintenance for removing the white deposits forming on the engine components and the installation of a pretreatment system (carbon adsorption) to remove siloxanes prior to combustion. Numerical analyses showed that for the facilities with operating capacities less than 1300 m3/h (750 scfm), the costs for installation and operation of the carbon adsorption system exceeded the maintenance costs for removal of deposits from the engine components. The maintenance costs correlated well with the reported maintenance needs which were between 120 and 800 man hours per year. On the basis of siloxane removal costs alone, it is not economically feasible to install a carbon adsorption system for siloxane removal prior to combustion for small facilities processing less than 1300 m3/h (750 scfm) of biogas. However, using a process for siloxane removal prior to gas engines (e.g., carbon adsorption) would be improve the overall performance of the gas engines and reduce maintenance need at all facilities.

Basement oil of sedimentary basins is an alternative of “shale” scenario of global FEC development (West Siberia as an example)

Concepts on structure, composition and oil presence of the West Siberia basement are considered in the paper. Information on oil and gas presence in the basement of the world is presented, its inexhaustible potential is unveiled. Critical analysis of concepts on oil genesis in the basement of West Siberia as well as in White Tiger deposit has been given on the basis of the theory of organic origin and descending oil migration while producing the deposits. Principles of alternative inorganic image of the “basement oil” based on the ideas of the “Deep oil” are discussed. Problems of formation of West Siberia oil deposits have been considered in an aspect of history of West Siberia development; features of structure and search and exploration methods of occurrences in basement fissure collectors; geological signs and criteria of mapping basement displacements of channels of deep oil vertical migration localized on the bodies. “Complex Program for development of the West Siberia basement on the grounds of HC deep genesis” has been proposed. Basement oil of sedimentary basins is considered as a primary alternative of a “shale” scenario of the world FEC development. Alternative scenario of development and renewal of the world FEC from inevitable stagnation suggests immediate change from organic paradigm of oil-gas geology of Gubkin—Vassoyevich—Kontorovich to its antagonistic-alternative inorganic theory of Mendeleev—Kudryavtsev—Porfiriev. Otherwise, no “shale revolution” and alternative energetics will help the world fuel complex to avoid energetic crisis and society to come back to “stone” (coal) age, before coming to the next level of hydrogen energy.

Linking chemical exposure to lipid homeostasis: A municipal waste water treatment plant influent is obesogenic for zebrafish larvae

Obesity, a risk factor for the development of type-2 diabetes, hypertension, cardiovascular disease, hepatic steatosis and some cancers, has been ranked in the top 10 health risk in the world by the World Health Organization. Despite the growing body of literature evidencing an association between the obesity epidemic and specific chemical exposure across a wide range of animal taxa, very few studies assessed the effects of chemical mixtures and environmental samples on lipid homeostasis. Additionally, the mode of action of several chemicals reported to alter lipid homeostasis is still poorly understood. Aiming to fill some of these gaps, we combined an in vivo assay with the model species zebrafish (Danio rerio) to screen lipid accumulation and evaluate expression changes of key genes involved in lipid homeostasis, alongside with an in vitro transactivation assay using human and zebrafish nuclear receptors, retinoid X receptor α and peroxisome proliferator-activated receptor γ. Zebrafish larvae were exposed from 4 th day post-fertilization until the end of the experiment (day 18), to six different treatments: experimental control, solvent control, tributyltin at 100 ng/L Sn and 200 ng/L Sn (positive control), and wastewater treatment plant influent at 1.25% and 2.5%. Exposure to tributyltin and to 2.5% influent led to a significant accumulation of lipids, with white adipose tissue deposits concentrating in the perivisceral area. The highest in vitro tested influent concentration (10%) was able to significantly transactivate the human heterodimer PPARγ/RXRα, thus suggesting the presence in the influent of HsPPARγ/RXRα agonists.Our results demonstrate, for the first time, the ability of complex environmental samples from a municipal waste water treatment plant influent to induce lipid accumulation in zebrafish larvae.

Sharma's sigmoid colonic adhesive band – A new laparoscopic sign in female genital tuberculosis

BackgroundFemale genital tuberculosis (FGTB) is a form of extra pulmonary tuberculosis (EPTB) affecting women of reproductive age group. It causes significant morbidity in women especially infertility particularly in developing countries. Diagnosis is by endometrial sampling for acid fast bacilli (AFB) microscopy, culture, gene Xpert, polymerase chain reaction (PCR), histopathological evidence of epithelioid granuloma and by laparoscopic findings suggestive of tuberculosis. AimPresent study was conducted to observe the prevalence of a new “Sharma's Sigmoid colonic adhesive band “in FGTB on laparoscopy. MethodsIt was a prospective study in a tertiary referral center as a part of our ongoing tuberculosis project on 148 infertile women found to have FGTB on microbiological or laparoscopic findings over previous 10 years. A new laparoscopic “Sharma's Sigmoid colonic adhesive band” was looked for in these cases on laparoscopy. ResultsThe mean age, parity and duration of infertility and incidence of poor socioeconomic status was 26.9 years, 0.49, 5.3 years and 65.54% respectively. All patients had infertility with 83.78% primary and 16.22% secondary infertility while menstrual dysfuction especially hypomenorrhoea (31.75%), oligomenorrhoea (32.48%) were seen in respective cases. Constitutional symptoms like pyrexia (21.62%), weight loss (31.75%) appetite loss (33.5%) and abdominal pain (11.48%) and pelvic pain (27.70%) or abdominal mass (8.78%) and pelvic masses (35.81%) were also seen. Diagnosis of FGTB was made on endometrial or peritoneal biopsy microscopy or culture for AFB or positive gene Xpert or positive polymerase chain reaction (PCR) or histopathological demonstration of epithelioid granuloma or on laparoscopic findings of FGTB. Various laparoscopic findings were tubercles on pelvic organs (45.27%), shaggy areas (white deposits) on pelvic organs (43.91%),beaded or convoluted tubes (9.45%), hyperemic tubes (29.05%), caseous nodules in pelvis (29.72%), encysted ascites (14.18%), abdominal adhesions (32.43%), pelvic adhesions (42.56%), calcified and rigid tubes (6.08%). The new laparoscopic sigmoid colonic adhesive band was seen in 49 (33.10%) patients of FGTB. ConclusionThe new laparoscopic “Sharma's Sigmoid colonic adhesive band” appears to be an important finding in patients with FGTB.

Ectopic Ocular Surface Calcification in Patients With Hypophosphatasia Treated With Asfotase Alfa

To assess for ectopic ocular calcification in a series of patients with hypophosphatasia (HPP) treated with asfotase alfa, a recombinant tissue-nonspecific alkaline phosphatase. This is a retrospective analysis of subjects enrolled at Duke University Medical Center in ENB-009-10 (ClinicalTrials.gov: NCT01163149), a randomized controlled trial of asfotase alfa in adolescents and adults with HPP. Seven patients between the ages of 45 and 66 years diagnosed with HPP based on clinical features and low serum alkaline phosphatase levels were enrolled at our site. Subjects were randomized to receive either daily subcutaneous injections of asfotase alfa or no treatment. After 24 weeks, during the open-label extension phase, all subjects received treatment for at least 4 years. All subjects underwent comprehensive eye examinations at baseline and at 24-week intervals throughout the study to assess for development of ocular calcifications. By week 120, all 7 subjects developed asymptomatic white refractile deposits in the interpalpebral perilimbal conjunctiva. Biopsy of the conjunctival lesions in 2 subjects revealed elastosis with subepithelial calcification. The lesions were nonprogressive and in 5 subjects exhibited some degree of regression. Asfotase alfa was invariably associated with development of mild focal conjunctival calcification, likely through disinhibition of hydroxyapatite crystal propagation. The calcifications were not symptomatic or vision-threatening and should not preclude enzyme replacement therapy for patients with this rare and often debilitating disease.

Microbial diversity of Baeg‐nyong cave and characterization of the antibiotics extracted from Streptomyces exfoliatus

Baeg‐nyong (BN) cave is a one of the natural cave and critical zone observatory (CZO) in the Republic of Korea, but the role of microbial species in BN cave is still not well‐known. To analyze the microbial diversity of the cave, we collected a moonmilk, which is a white deposit of limestone cave. Because moonmilk has different textures depending the moisture contents, we performed metagenomics for two moonmilks (Dry and wet moonmilk) by next generation sequencing (NGS). The results of metagenomics revealed that moonmilks have very different microbial community and dominant species to each other. Specifically, Chromatiales, Pseudomonas, and Steroidobacter groups are present in high percentages in dry moonmilk, and Xanthomonadales and Arthrobacter group are dominant bacteria in wet moonmilk. Specifically, Streptomyces species of Actinobacteria are only present in dry moonmilk, and surface analysis showed that only dry moonmilk contained round‐shaped calcite structures, which might be affected by Streptomyces. Therefore, we isolated nine Streptomyces spp. from dry moonmilk and characterized their morphological, cultural, physiological, and biochemical properties. Among the nine Streptomyces species, only one species, as known as Streptomyces exfoliatus, showed the antimicrobial activity against to some bacteria including E. coli and B. subtilis. In addition, we extracted the antimicrobial compound from S. exfoliatus and analyzed HPLC and various assays to establish the antibiotics of S. exfoliatus isolated from BN cave.Support or Funding InformationThis research is supported by NRF‐2015R1D1A1A02061743 and NRF‐2015R1A4A1041105.This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Four millennia of dairy surplus and deposition revealed through compound-specific stable isotope analysis and radiocarbon dating of Irish bog butters\xa0

Bog butters are large white or yellow waxy deposits regularly discovered within the peat bogs of Ireland and Scotland. They represent an extraordinary survival of prehistoric and later agricultural products, comprising the largest deposits of fat found anywhere in nature. Often found in wooden containers or wrapped in animal bladders, they are considered to have been buried intentionally by past farming communities. While previous analysis has determined that Irish bog butters derive from animal fat, their precise characterisation could not be achieved due to diagenetic compositional alterations during burial. Via compound-specific stable isotope analysis, we provide the first conclusive evidence of a dairy fat origin for the Irish bog butter tradition, which differs from bog butter traditions observed elsewhere. Our research also reveals a remarkably long-lived tradition of deposition and possible curation spanning at least 3500 years, from the Early Bronze Age (c. 1700 BC) to the 17th century AD. This is conclusively established via an extensive suite of both bulk and compound-specific radiocarbon dates.

Impact of smoking on efflorescence formation on dry-fermented sausages

Abstract The formation of white deposits (efflorescences) on the surface of dry-fermented sausages has been an increasing challenge in the European meat processing industry. As such, the current study investigated the impact of smoking on the formation of efflorescences. We therefore utilized a multistep procedure. Firstly, dry-fermented Salami-type sausages (20 mm caliber) were produced and subsequently exposed to different smoking times (0, 30, 60, and 120 min). Secondly, modified atmosphere was applied to induce efflorescence formation on Salami-type sausages over a storage period of 8 weeks. Thirdly, the surface of the sausages was analyzed by both visual and chemical methods to quantify the amount and major components, which induce the formation of efflorescences. The results revealed that multiple effects simultaneously occurring influenced the efflorescence formation. An increase in smoke exposure significantly decreased the amount of efflorescences on the surface during storage (0 min = 31.6% >30 min = 24.6% >60 min = 7.5% > 120 min = 3.4%) due to a decrease in surface pH. In addition, magnesium, lactate, and creatine were identified as the major components depositing on the surface of the sausages during smoking and storage. Statistical analysis showed high correlation scores between visual and chemical analysis (0.751–0.971), particularly of magnesium indicating its function as a major agent in the formation of efflorescences. Our results might have important implications for the production of processed meat products.

Sulfuric acid speleogenesis in the Majella Massif (Abruzzo, Central Apennines, Italy)

Many active and inactive hypogene sulfuric acid cave systems are known along the Apennines, Italy. The Cavallone-Bove cave system is located in the external part of the central Apennine Chain, in the Majella Massif, and opens at 1470 m asl along the Taranta Gorge (South of Chieti). The presence in these caves of peculiar geomorphological features, such as feeders, rising channels, megacusps, cupolas, and replacement pockets, offers evidence of rising acidic fluids. The secondary mineral deposits, including meter-size white gypsum deposits, alunite, jarosite, black layers of iron‑manganese oxides and hydroxides, along with a rare association of authigenic rutile-ilmenite minerals indicate a sulfuric acid origin. Stable isotope analyses of sulfates further confirm a sulfuric acid speleogenetic (SAS) origin of these minerals and, in general, of the whole cave system, with H2S coming from the bacterial sulfate reduction of deep-seated Triassic evaporites interacting with hydrocarbons. Alunite dating demonstrates this water table SAS cave to have been active at least until 1.52 ± 0.28 Ma. All the evidence suggests that Cavallone-Bove is an ancient sulfuric acid karst system that was uplifted <1 km above pre-existing base level. The age of speleogenesis further suggests that tectonic uplift of this area was as high as 670 m My−1 over the last 1.5 Ma.

Large-scale opacification of a hydrophilic/hydrophobic intraocular lens.

To determine the prevalence and risk factors related to the opacification of the LS-502-1 intraocular lens. Cross-sectional study including patients submitted to cataract surgery between January 2010 and March 2012, with implantation of the LS-502-1 intraocular lens. Past medical history was registered and a complete ophthalmologic evaluation, that included best-corrected visual acuity, slit-lamp examination and fundoscopy, was performed. Anterior segment photographs were taken whenever intraocular lens opacification was present. One hundred and sixty-nine eyes of 154 patients were included, mean age 78.5 ± 7.9 years. The average follow-up after intraocular lens implantation was 65.6 ± 10.0 months. Intraocular lens opacification was seen in 53.3% (n = 90) and presented as one of four different patterns: peripheral (15.6%, n = 14), central (4.4%, n = 4), diffuse (71.1%, n = 64) and superficial white deposits (8.9%, n = 8). There was no statistically significant association with systemic or ophthalmic conditions. In patients with bilateral implantation, intraocular lens opacification in one eye was significantly related to intraocular lens opacification in the fellow eye. A significant variability in opacification was found across intraocular lens serial numbers: the odds ratio for opacification in intraocular lens with serial number beginning with 200003 was 6.0 when comparing with the remaining lenses. The opacification prevalence of the LS-502-1 intraocular lens was 53.3%, which is the highest ever described for any intraocular lens model. Our results suggest that this occurrence is secondary to an interaction between unknown patient variables and problems related to intraocular lens manufacturing and storage procedures.

Analisis Kualitatif Kandungan Sulfat dalam Aliran Air dan Air Danau di Kawasan Jakabaring Sport City Palembang

Analytical chemistry is one branch of chemistry in which there is a way to determine certain ion levels using selective and specific reagents. One type of ion that can be known is the sulfate ion. Sulfate ions are one of the main anions that appear in water naturally. Sulfate is one of the important ions in water availability because of its important effect on humans when it is available in large quantities. The maximum limit of sulfate in water is around 250 mg / L for human-consumed water. This study uses qualitative analysis to determine whether water in the Jakabaring Sport City Palembang region contains sulfate ions or not. Samples taken directly from five different points were reacted with HCl and BaCl2. The results obtained are the five positive water samples containing sulfate ions which are characterized by the formation of white deposits.

Postoperative Endophthalmitis Caused by Candida Parapsilosis: A Case Report

Purpose: To report an unusual case of postcataract endophthalmitis secondary to Candida parapsilosis. Case Presentation: A 77-year-old female patient was admitted to the emergency ward with reduced visual acuity (VA), and redness and pain in the right eye (RE) with a few hours of evolution. The patient underwent cataract surgery in the right eye 50 days earlier; no abnormalities were discovered in postsurgery check-ups on the following days. Biomicroscopy revealed corneal oedema, tyndall ++++, and flare +++. Capsule-shaped whitish deposits and posterior synechiae were also reported. Fundoscopy: not visible due to anterior segment opacity. RE ultrasound: mild vitritis, attached retina. Due to a strong suspicion of endophthalmitis, an aqueous humour biopsy was performed and the presence of Candida parapsilosis sensitive to amphotericin B and voriconazole was revealed. In view of a poor prognosis, we decided to carry out a vitrectomy, removal of the IOL + capsular bag complex and intravitreal injection of amphotericin B. After several check-ups, the patient reported being diagnosed with a fungal infection in her fingernails some time ago. She was referred for a microbiological testing, which confirmed the presence of Candida in the fingernails. Conclusions: Fungal endophthalmitis is uncommon in the postoperative setting, with most of the cases being attributable to the Candida species. The combination of pars plana vitrectomy, removal of the IOL + capsular bag complex and antifungal agents was able to successfully treat this case of postoperative endophthalmitis due to Candida parapsilosis. The relationship between postoperative Candida endophthalmitis and Candida nail infection is dramatic. To date, only one case of endogenous endophthalmitis associated with complicated onychomycosis has been reported.

Calcite moonmilk of microbial origin in the Etruscan Tomba degli Scudi in Tarquinia, Italy

A white deposit covering the walls in the Stanza degli Scudi of the Tomba degli Scudi, Tarquinia, Italy, has been investigated. In this chamber, which is still preserved from any kind of intervention such as cleaning and sanitization, ancient Etruscans painted shields to celebrate the military power of the Velcha family. Scanning electron microscopy analysis has revealed the presence of characteristic nanostructures corresponding to a calcite secondary mineral deposit called moonmilk. Analysis of the microbial community identified Proteobacteria, Acidobacteria and Actinobacteria as the most common phyla in strong association with the moonmilk needle fibre calcite and nanofibers of calcium carbonate. Employing classical microbiological analysis, we isolated from moonmilk a Streptomyces strain able to deposit gypsum and calcium carbonate on plates, supporting the hypothesis of an essential contribution of microorganisms to the formation of moonmilk.

Microbiome profiling in extremely acidic soils affected by hydrothermal fluids: the case of the Solfatara Crater (Campi Flegrei, southern Italy).

An integrated geochemical and microbiological investigation of soils from the Solfatara Crater (Campi Flegrei, southern Italy) demonstrated that interstitial soil gases dominated by CO2 and other typical hydrothermal gaseous species (e.g. H2S, CH4, ethane, benzene, alkenes and S-bearing organic compounds) influenced the composition of microbial communities. The relatively high concentrations of hydrothermal fluids permeating the soil produced acidic conditions and whitish deposits that characterize the Solfatara Crater floor. Archaea and Bacteria showed almost equal cell abundance (up to 3.2×107 and 4.2×107 cell/g, respectively) with relatively low levels of biodiversity and equitability in sites characterized by elevated temperatures (up to 70°C), very low pH values (up to 2.2) and reducing conditions. In these sites, high-throughput sequencing showed the marked selection of microorganisms, mainly affiliated with the genera Thermoplasma, Ferroplasma and Acidithiobacillus. A relatively high biodiversity and concomitant distinctive structure of the microbial community were observed in soils poorly affected by fumarolic emissions that were oxic and rich in organic matter.

Deterioration of residential concrete foundations: The role of pyrrhotite-bearing aggregate

Premature deterioration of concrete foundations has been reported for a large number of homes in Eastern Connecticut of the United States. The characteristic symptoms are map cracking, whitish deposits at the vicinity of the cracking surface and wide crack opening. It is hypothesized that the volume expansion associated with the oxidation of pyrrhotite-bearing aggregate and the following internal sulfate attack (ISA) due to the delayed secondary mineral formation are the primary causes of premature deterioration. Extensive tests were carried out to validate the hypothesis using a combination of tools such as scanning electron microscopy (SEM), X-ray diffraction (XRD), X-ray fluorescence (XRF) and energy dispersive X-ray (EDX).The results showed that pyrrhotite and its oxidation products, such as ferrihydrite, goethite and sulfur, were present in or at the surface of the aggregates of the deteriorated concrete, suggesting the occurrence of pyrrhotite oxidation. Expansive secondary mineral formations (SMF) such as ettringite and thaumasite were also identified. The abundance of these SMFs, their spatial distribution in the open spaces together with their close association with matrix cracking suggest the cause of premature deterioration.

Ocular Findings in Exfoliation Syndrome.

Exfoliation syndrome is characterized by numerous ocular manifestations, the most important of these being glaucoma and cataract. Its ocular manifestations affect all of the structures of the anterior segment as well as conjunctiva and orbital structures. Exfoliation material is seen most prominently as characteristic white deposits on the anterior surface of the lens and the pupillary border of the iris. Both open-angle and angle-closure glaucoma are intimately associated with exfoliation syndrome. Other findings include zonular disruption, iris sphincter fibrosis, keratopathy, ocular surface disease, and retinal vein occlusion.

Tongue Cleaning Increases the Perceived Intensity of Salty Taste.

Tongue coating, which refers to a greyish white deposit on the tongue surface, often covers the taste papillae on the dorsal tongue surface, decreasing taste sensitivity. This study investigated whether mechanical removal of the tongue coating affected the intensity of salt taste perception. This cross-sectional single blind study included 90 subjects (29 males, 61 females) with a mean age of 45 years (range 25-70 years). The presence and the amount of coating on the six sextants of the tongue were scored using the Winkel Tongue Coating Index (WTCI); the 90 included subjects had total WTCI scores ≥ 3. The intensity of the salt taste was tested using a drop of prepared tomato soup applied to the middle of the dorsal surface of the tongue before and then after tongue cleaning. The salt taste intensity was measured using a general Labeled Magnitude Scale (gLMS). The mean salt taste intensity was significantly different (p value = 0.0002) after the intervention versus before it, with the taste intensity increasing after tongue cleaning. The results indicated that the salt taste intensity increased after removal of the tongue coating. This study indicates that tongue cleaning, a simple technique used for oral hygiene, may be an effective way to reduce excess salt intake. Tongue cleaning could help individuals adhere to the WHO recommendations on dietary salt intake.