Introduction: Systemic lupus erythematosus (SLE) is a multi-organ inflammatory disease associated with autoimmune diseases. The aim of the study is to assessed the frequency of celiac disease (CD) in adults and children with SLE (aSLE and cSLE, respectively) and compare them with rheumatoid arthritis (RA) and juvenile idiopathic arthritis (JIA) patients; the study also explored the clinical impact of CD serologic markers on SLE disease activity and severity. Methods: This was a cross-sectional study. Patients with SLE who had regular follow-up in rheumatology clinics were evaluated for laboratory and clinical variables using serology and the SLE Disease Activity Index (SLEDAI). To assess the occurrence of CD serology in cSLE and aSLE and the clinical impact of CD serologic markers on SLE, patients were tested for antigliadin (AGA), anti-endomysium (EmA) and anti-tissue transglutaminase (tTG) antibodies. RA and JIA patients were included for comparison. Duodenal biopsy was conducted in patients who exhibited CD markers. Results: The CD marker was found in 29 (11.6%) of the 250 patients. AGA was present in seven aSLE patients and tTG in two (11.1%). Among cSLE patients, the autoantibody was present in 17.6% (AGA in four, tTG in two, and EmA in three). For RA patients, five had AGA and tTG and one had EmA, with an overall positivity of 9.7%. Five JIA patients had AGA (four with EmA and five with tTG) with overall positivity of 10.9%; the serum IgA level was normal in all patients except one. Duodenal endoscopic biopsy was performed in patients with positive CD markers (two declined). Histologic confirmation of CD was reported in one RA and one JIA patient but in none of the SLE patients. There was no correlation between the presence of CD markers and autoantibodies in SLE. Conclusion: CD antibodies did not influence SLE activity. Thus, SLE patients may not need to be screened for CD antibodies.
Background: COVID19 pandemic has deleterious effect on mental health of people around world. Like medical professionals, students of tertiary care center are also at higher risk of developing anxiety related to COVID19. Objectives: To assess severity of COVID19 related anxiety and identify underlying risk factors among students of different courses of tertiary care center. Materials and Methods: A cross-sectional online survey was conducted including 704 students aged above 18 years from different courses of tertiary care center. Study was conducted after obtaining clearance from Institutional Ethical Committee and informed consent was obtained online. Anxiety related to COVID19 was assessed using COVI19 Anxiety Syndrome Scale (COVID19ASS). Statistical analysis for descriptive data was done by using mean and percentage. Results: Study comprised of 50.4% female and 49.6% male students with mean age of 20+4 and 21+3 years respectively. Mean COVID19ASS scores of male and female students was found to be 18.6 (SD=4.3) and 19.7 (SD=3.8) with no statistically significant difference (p value=0.41, x2= 2.87, df- 3). In factor analysis, age group 18- 20 years, students in first year MBBS, first and second year of paramedical/nursing course, postgraduates, history of COVID19 infection in the past, history of either infection or death due to COVID19 in family or friend were significant risk factors for perseveration and avoidance behavior. Conclusion: Students who report of pandemic associated anxiety should be thoroughly interviewed for severity of symptoms. This may help in early identification of mal-adaptive behavior, so that early intervention either pharmacological or psychological therapy can be initiated.
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