Based to a great extent upon mainly anecdotal case reports and theory, there is a general acceptance that patients on longterm systemic steroid medication should receive supplementary glucocorticoids or 'steroid cover' when undergoing certain types of stressful treatment including dentistry. The theoretical basis to this practice is that exogenous steroids suppress adrenal function to an extent that insufficient levels of cortisol can be produced in response to stress, posing the risk of acute adrenal crisis with hypotension and collapse. The purpose of this paper is to review relevant literature and propose clinical guidelines for dental practitioners. Of numerous reported cases of adrenal crisis following procedural interventions, few stand up to critical evaluation. Other reviewers have reached similar conclusions. A number of studies confirm the low likelihood of significant adrenal insufficiency even following major surgical procedures. Various authors have suggested modified guidelines for management of patients on steroid medications. Patients on long-term steroid medication do not require supplementary 'steroid cover' for routine dentistry, including minor surgical procedures, under local anaesthesia. Patients undergoing general anaesthesia for surgical procedures may require supplementary steroids dependent upon the dose of steroid and duration of treatment.

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Summary Food is a basic human physiological need that is important for survival, growth, health and general well‐being. Without an adequate supply of food, a human being can neither grow or develop optimally, nor utilize energy for sustained livelihood, thereby implying food insecurity. South Africa (SA) is classified as a developing country, with developing countries representing a third of the world's population. Unfortunately, as is often the case in developing countries, limited up‐to‐date surveys and consumption data are available. In fact, SA has only ever had one National Food Consumption Survey (NFCS) in 1999, in preparation for the introduction of a food fortification programme. However, the available information still sketches the severity of the situation within emergent economies. It is recognised that modern rates of food inflation are a worldwide phenomenon and it is argued that SA as a case study presents a much wider insight than just an individual country. About 35% of the South African population is food insecure and categorized as being poor. With the current continual increase in food prices, especially staple food prices, most households need to employ food coping strategies to survive. Some of these strategies have a significant negative impact on their often already deprived nutritional status. The possible added impact of current inflation on the nutritional status of vulnerable South African households is discussed in this paper. A consequent potential reduction in portion sizes of staple foods consumed because of increased food prices, as well as a snapshot of the cost of a balanced varied diet compared with average household income, are presented in the context of SA's prevailing inadequate nutritional situation.

The glycemic index (GI) is a measurement used to classify foods according to their potential for raising blood glucose levels. The GI of a foodstuff is generally measured by determining the increment in blood glucose concentration after the consumption of a test meal over a set period of time and comparing it with an isoglucosidic control meal (normally white bread or glucose) and expressed as a percentage within a group of individuals (in vitro). Rapid analysis methods (in vivo) have been evaluated worldwide, and in many cases these values have correlated with the GI values determined by in vitro methods. The critic against rapid analysis methods are that the methods do not provide a numerical GI values, although proposed labelling legislation in South Africa recommends that suppliers should only indicate if the product has a high, intermediate or low GI. The purpose of this study was to investigate existing rapid assessment methods for the prediction of GI, and develop such a method for South Africa to be used by food producers in line with the newly proposed national labelling requirements. The preliminary studies on the developed rapid assessment method indicated good repeatability (CV 0.78%), reproducibility and precision (CV 3.5%), and can accurately predict a foods GI category, being high, intermediate or low GI.