ABSTRACT
The most prevalent malnutrition issues in Sri Lanka are the protein-energy malnutrition (PEM), vitamin A deficiency, and iron deficiency. Childhood and adolescence are the crucial stages of life which mostly susceptible to malnutrition since their major physiological and psychological changes take place. Although a balanced, nutritious diet is essential to them, present socio-economical and higher academic expectations have created a complex environment that often pushes them towards junk foods and unhealthy snacks. The objective of the present study was to develop ready-to-reconstitute convenient mid-day meals in three categories of chicken, fish, and soya, which match to the Sri Lankan local culinary style, with acceptable sensory properties to upgrade the nutritional status of school children (5-10 yrs) and adolescents (11-19 yrs). Those mid-day meals were designed according to the Food-Based Dietary Guidelines (FBDG) of Sri Lanka. The selected ingredients were processed; rice to instant rice, vegetables to dehydrated vegetables, and protein source of chicken, fish, and soya to pre-cooked sterilized curry pouches. The convenient mid-day meal packages were prepared using three portions of instant rice containing 10% of green gram flakes, dehydrated vegetables, and retorted curry mix respectively. Labeling was performed according to the type of curry mix inserted into the package as Chicken, Fish, or Soy mid-day meals. Physicochemical and sensorial properties of meals were evaluated. The caloric value of mid-day meals ranged 575 - 640.82 kcal. The protein content of meals ranged from 25.88 g to 32.68g and there was no significant difference (p<0.05) between protein contents in chicken and fish meals. The fat contents and dietary fiber contents significantly (p<0.05) differed and the highest contents of fat (3.15 g) and dietary fiber (4.40 g) were observed in chicken meal and soy meal respectively. The mineral contents of tested meals significantly differed (p<0.05) and the significant highest Ca, Fe, K, Fe, and P were observed in soya mid–day meals. The highest mean rank scores for all sensory attributes in terms of odor, appearance, texture, taste, and overall acceptability were observed in the chicken mid-day meal. Ready-to-reconstitute mid-day meals in three categories of chicken, fish, and soya, which could match to the Sri Lankan local culinary style, were developed with acceptable sensory properties.
ABSTRACT
Background: There are 2 dimensions of childcare quality: process and structure. The interactions, activities, materials, learning opportunities, health and safety routines refer to process quality. Structural quality includes the group size, adult-child ratio and professional training of staff. No large scale studies are available on the quality of Sri Lankan childcare centres. Objectives: To assess the quality of preschool and day care centres in the Colombo Municipal Council (CMC) area and to evaluate how structural inputs and cost influence the process quality. Design: Descriptive cross-sectional qualitative study Method: Process quality was assessed using the Early Childhood Environmental Rating Scale-Revised. The cost and structural quality was assessed using a self-administered questionnaire. Results: Overall process quality was mediocre, with 25% preschools being of poor quality and 6% being of good quality. Over half the centres did not have appropriate number of staff. Eighty percent of child groups were larger than appropriate. Only 8% of centres were led by a graduate. Of the teachers, 90% had preschool teacher training. Smaller student groups cared for by a higher number of staff had significantly higher process quality. Better quality preschools cost more. Conclusions: The quality of care provided by childcare centres in the 6 Medical Officer of Health areas of CMC area was mediocre.
ABSTRACT
Objective: To evaluate the feasibility of performing the single stage primary laparoscopic pullthrough (PLPP) surgery for Hirschprung disease (HD) to avoid the morbidity associated with traditional staged multiple surgery. Method: PLPP was performed on 12 patients with histologically diagnosed, uncomplicated HD below the age of 4 years since April 2010. Adequate bowel preparation was achieved prior to surgery. Four-port video laparoscopy was performed. The transition zone was identified with biopsies and confirmed with frozen section. Colon and rectum were mobilized close to its wall up to the pelvic floor. Rectal prolapse was induced intussuceptically and the rectum transected 2cm above the dentate line. Colon was pulled down through anus and divided at biopsy site level. Colo-anal anastomosis was performed over a rectal tube. Results: A noteworthy improvement of bowel habits and general well being was expressed by parents during follow-up assessment. Early results from our study, as well as the long-midterm results from elsewhere in the world, suggest that the PLPP is superior to the traditional staged procedure. Conclusion: PLPP is a better, safer and more effective approach of treating HD.