Participatory Action Research to Developing Acceptable Provitamin a Fortified Gari

There is severe clinical vitamin A deficiency (VAD) prevalence among Ghanaians and many African countries. Foodbased diets has been suggested as a more sustainable approach to solving the VAD situation in Africa. In this study, A participatory action research between orange flesh sweet potato farmers, gari processors within central region and academia was adopted to develop gari containing provitamin A beta-carotene. Gari is a major staple for Ghanaians and people in the West African subregion due to its affordability and swelling capacity. It is mainly eaten raw with water, sugar, groundnut and milk as gari-soakings or with hot water to prepare gelatinized food called gari-kai in Ghana or “eba” among Nigerians. However, gari is limited in provitamin A carotenoids. Orange fleshed sweet potato (OFSP) is known to contain large amount of vitamin A precursor. Therefore, addition of OFSP to gari would have the potential to fight the high prevalence rate of vitamin A deficiency amongst less developed regions of Africa. To develop this, different proportions of orange fleshed sweet potatoes (OFSP) was used to substitute cassava mash and fermented spontaneously to produce composite gari - a gritty-crispy ready-to-eat food product. Both the amount of OFSP and the fermentation duration caused significant increases in the β-carotene content of the composite gari. OFSP addition reduced the luminance while roasting made the composite gari yellower when compared with the cake used. Addition of OFSP negatively affected the swelling capacity of the gari although not significant. The taste, texture, flavour and the overall preferences for the composite gari decreased due to the addition of the OFSP but fermentation duration (FD) improved them. The sample with 10% OFSP and FD of 1.81 days was found to produce the optimal gari. One-portion of the optimal gari would contribute to 34.75, 23.2, 23.2, 27, 17 and 16% of vitamin A requirements amongst children, adolescent, adult males, adult females, pregnant women and lactating mothers respectively. The study demonstrated that partial substitution of cassava with OFSP for gari production would have the potential to fight the high prevalence rate of vitamin A deficiency amongst less developed regions of Africa while involvement of farmers and processors prior to the design of research phase enhanced the adoption of intervention strategies

Effects of two pre-treatments, blanching and soaking, as processing modulation on non-enzymatic browning developments in three yam cultivars from Ghana

Non-enzymatic browning develops in dry-cooked foods and those with high carbohydrate develop acrylamide, a neurotoxin and potential carcinogen. However, some non-enzymatic browning products have reducing properties. We hypothesized that non-enzymatic browning and reducing power, a measure of antioxidant activity, of processed yam are affected by pre-treatment. Peeled yam cultivars (KM, RKD and SO89) in chunks were pre-soaked (0, 3, 6, 12, 18, and 24 h) in distilled water or pre-blanched (0, 1, 2, 3, 4, and 5 min) in steam. Pre-treated samples were deep-fried at 180 °C for 15 min or roasted at 220 °C for 30 min. Soluble solids, titratable acidity and pH of yam tissues and soaking water were determined. pH of the soaked yam tissues showed a positive relation with non-enzymatic browning. Pre-soaked fried KM and roasted RKD showed a significant decrease in non-enzymatic browning intensities. The reducing power of the cooked yams ranged between 78.94 and 185.92 % of ascorbic acid, and was affected by the different pre-treatment and dry-cooking methods

Pancreatic surgery outcomes: multicentre prospective snapshot study in 67 countries

Background: Pancreatic surgery remains associated with high morbidity rates. Although postoperative mortality appears to have improved with specialization, the outcomes reported in the literature reflect the activity of highly specialized centres. The aim of this study was to evaluate the outcomes following pancreatic surgery worldwide.Methods: This was an international, prospective, multicentre, cross-sectional snapshot study of consecutive patients undergoing pancreatic operations worldwide in a 3-month interval in 2021. The primary outcome was postoperative mortality within 90 days of surgery. Multivariable logistic regression was used to explore relationships with Human Development Index (HDI) and other parameters.Results: A total of 4223 patients from 67 countries were analysed. A complication of any severity was detected in 68.7 percent of patients (2901 of 4223). Major complication rates (Clavien-Dindo grade at least IIIa) were 24, 18, and 27 percent, and mortality rates were 10, 5, and 5 per cent in low-to-middle-, high-, and very high-HDI countries respectively. The 90-day postoperative mortality rate was 5.4 per cent (229 of 4223) overall, but was significantly higher in the low-to-middle-HDI group (adjusted OR 2.88, 95 per cent c.i. 1.80 to 4.48). The overall failure-to-rescue rate was 21 percent; however, it was 41 per cent in low-to-middle-compared with 19 per cent in very high-HDI countries.Conclusion: Excess mortality in low-to-middle-HDI countries could be attributable to failure to rescue of patients from severe complications. The authors call for a collaborative response from international and regional associations of pancreatic surgeons to address management related to death from postoperative complications to tackle the global disparities in the outcomes of pancreatic surgery (NCT04652271; ISRCTN95140761)