Butterflyene: an entry into an aesthetically pleasing carbocycle via a Diels-Alder reaction on a tetrasubstituted olefin.

An interesting molecular architecture, butterflyene, resembling the shape of a butterfly has been synthesized via a sequence of cyclocondensation, benzylic oxidation, McMurry coupling and Diels-Alder reaction (DAR), successively. The DAR of the tetrasubstituted double bond of a bicyclopentylidene moiety with various dienes has been performed to prepare the analogues of butterflyene. DFT calculations have also been used to analyze the structural optimization and reaction energies.

Vaccine hesitancy towards COVID vaccine among unvaccinated frontline health care workers working in a designated COVID care center: A cross-sectional study.

Background: Frontline health care workers (FLHCW) like doctors and nurses are bound to treat COVID patients being themselves not immune to disease are at a greater risk of COVID infection than the general population. The study was started with objectives to find out the vaccine hesitancy towards the COVID vaccine and to find out the factors associated with vaccine hesitancy among FLHCW working in a designated COVID care center. Materials and Methods: The present study was a cross-sectional study carried out for a period of 6 months from Jan 2021 to June 2021 at a designated COVID care center. FLHCWs who were part of treating COVID patients were our study participants. Among them, FLHCWs who had not received even one dose of COVID vaccine (Covishield) were included in the study. FLHCWs who had been part of the COVID vaccine trial were excluded from the study. The sample size calculated based on a previous study found to be 240. The data collected were entered into a Microsoft office excel sheet, analyzed using SPSS v 22(IBM Corp). Descriptive statistics were applied, and parametric tests were used to compare among the groups with statistically significant P value lesser than 0.05. Results: A total of 121 (52.6%) of FLHCWs were aged more than 30 years, 118 (51.5%) were male participants, 100 (43.5%) were paramedics by occupation, 51 (22.1%) had contracted COVID infection, 202 (87.8%) had received information, education, and communication (IEC) regarding COVID vaccine. FLHCWs more than 30 years, male participants, currently not working in COVIDward, FLHCWs who had not received IEC about COVIDvaccination and paramedics had higher scores of Vaccine hesitancy, and the difference was statistically significant indicating vaccine hesitancy. Conclusion: Vaccine hesitancy remains a persistent global threat. Awareness campaigns can be tailored to specific locales to address identified concerns regarding vaccines.

Impact of ultraviolet-absorbing 2-hydroxy-4-quaternaryammoniumalkoxy benzophenone motif on photodegradation of disulfoton: a case study.

Pesticide deposits post-treatment and before diffusing inside the plants are exposed to sunlight. Many of them degrade into a variety of photoproducts that may be harmful to living beings through accidental ingestion. The addition of ultraviolet light absorbers to the pesticide formulations is an attractive strategy to prevent photodegradation of the pesticides. Water-soluble quaternary ammonium ultraviolet light absorbers (QAUVAs) were synthesized from 2,4-dihydroxy benzophenones (BP-1) and their structures were confirmed by 1H NMR, 13C NMR, UV, and FTIR. A cost-saving approach for the photoprotection of disulfoton insecticide using these QAUVAs is presented. All the four QAUVAs exhibit excellent UV screening effect. The insecticide disulfoton was recovered in much higher amounts (22.27 ~ 25.64% higher than control) when it was irradiated in the presence of QAUVAs in comparison with the amount of recovery of pesticide exposed in absence of them.

Multimodal imaging characteristics in eyes with vitreoretinal lymphoma treated with intravitreal rituximab.

PURPOSE: To characterize the imaging features in eyes with vitreoretinal lymphoma (VRL) using ultra-widefield fundus photography (UWF-FP), swept-source optical coherence tomography (SSOCT) and fundus autofluorescence (FAF) that are correlated to ongoing treatment with intravitreal Rituximab(IVR). METHODS: Retrospective observational imaging-based study of 15 treatment-naive eyes with VRL treated with IVR. All patients with primary VRL underwent vitreous biopsy using 23/25G microincision vitrectomy system for confirmation of diagnosis. All eyes received monthly IVR (1 mg/0.1 mL) injections till disease remission. Baseline clinical characteristics, treatment details, outcomes, and sequential imaging features on UWF-FP, FAF, and SSOCT were analyzed. OUTCOME MEASURES: Baseline features and changes in UWF-FP, FAF patterns, and SSOCT features in response to treatment RESULTS: Clinically, patients presented with sub-RPE deposits (n = 15), superficial retinal hemorrhages (n = 2), 'giant' RPE (retinal pigment epithelium) holes (n = 2), and anterior segment reaction (n = 1). Eyes were treated with mean 5.7 IVR injections (median: 5; range 1-13) over a mean 7.2 ± 4.9 months. During the course of treatment, two eyes developed superficial retinal hemorrhages with spontaneous resolution, 2 eyes developed CME, and 4 eyes developed characteristic 'leopard skin' pigmentation. Hyper-autofluorescence corresponding to areas of active lesions decreased with each treatment cycle and was finally replaced by hypo-autofluorescence. Serial OCTs showed regression of sub-RPE/subretinal deposits (n = 15), ellipsoid zone disruption (n = 9), and its resolution with treatment (n = 3), epiretinal membrane (ERM; n = 6), choroidal hyperreflective foci (HRF; n = 4), disorganization of retinal inner layers (DRIL; n = 3), RPE-rip (n = 2), cystoid macular edema (CME; n = 2), and hyperreflective lesions in the choroid (n = 1). Complete resolution was observed in all eyes with extensive hypo-AF. The central foveal thickness decreased from 237 ± 113 µ to 182 ± 114 µ (p = 0.1) and subfoveal choroidal thickness decreased from 258 ± 66 µ to 220 ± 64 µ (p = 0.12) at final follow-up. The mean baseline BCVA was logMAR 0.9 ± 0.9 that deteriorated to mean logMAR 1 ± 1 final visit (p = 0.7). The mean recurrence-free follow-up was 5.9 ± 5.1 months CONCLUSION: Multimodal imaging provides novel insights into features of VRL, a better understanding of regression patterns, and prognostication of outcomes when treated with intravitreal rituximab. Larger, multicentric studies with longer follow-up will help unravel imaging biomarkers to understand these aspects better.

Intravitreal rituximab monotherapy for management of eyes with vitreoretinal lymphoma: initial experience from India.

PURPOSE: To evaluate treatment outcomes and complications of intravitreal rituximab (IVR) monotherapy for eyes with vitreoretinal lymphoma (VRL). METHODS: Patients diagnosed with 'isolated primary VRL' or 'VRL with remission of systemic disease' and treated with IVR (1 mg/0.1 ml) between June 2014 and June 2019 were included in this retrospective, interventional case series. Injections were repeated at monthly intervals until complete resolution. All patients signed a written informed consent form. Institutional review board approval was obtained. RESULTS: Twelve eyes of 7 patients with VRL were treated with 77 IVR injections at mean 6.42 injections per eye (median = 5; range = 2-13) for complete resolution at mean 8.16 ± 4.62 months (median = 6.97 months; range = 1.97-14.33 months). Mean age at presentation was 53.3 years (median = 54 years; range = 34-74 years). Patients were co-managed with medical oncologist and periodically evaluated. Complications included anterior uveitis (n = 6), raised intraocular pressure (n = 3), posterior synechiae (n = 2), vitreous haemorrhage (n = 1), pre-retinal haemorrhage (n = 1), retinal detachment (n = 1), posterior subcapsular cataract (n = 2) and sectoral iris atrophy (n = 1). Recurrences were seen in 3 eyes (25%), which eventually achieved complete resolution with treatment. None of the patients had systemic involvement or death during follow-up. Mean follow-up was 18.73 ± 8.83 months (median = 21.60 months; range = 7.37-32.67 months). CONCLUSION: Intravitreal rituximab monotherapy is effective in management of vitreoretinal lymphoma in patients with isolated ocular disease.

Vitreous Seed Classification and Regression Patterns in Eyes With Retinoblastoma.

Purpose: This work subclassifies retinoblastoma vitreous seeds and evaluates the efficacy, regression patterns, and adverse effects of combination intravitreal melphalan and topotecan chemotherapy for resistant and recurrent vitreous seeds. Methods: A retrospective review of medical records was conducted of patients with retinoblastoma and resistant or recurrent vitreous seeds who were treated with intravitreal melphalan and topotecan injections from August 2014 to July 2018. Main outcome measures included regression pattern, time for regression, time for recurrence of seeds, treatment outcomes, and ocular toxicity. Results: Nineteen eyes received 138 intravitreal injections over 74 treatment sessions (mean, 7.26 injections per eye); vitreous seeds regressed in 18 eyes. Of cloud vitreous seeds, curvilinear (n = 2) and sphero-linear (n = 2) subtypes were observed. During regression, some sphere seeds showed an intermediary streak-like pattern and took longer to regress (mean, 11.13 ± 14.05 months and 11.67 ± 8.62 injections) than those without the intermediary streak-like pattern (mean, 3.55 ± 2.57 months and 4.2 ± 1.87 injections). Mean follow-up was 34.87 ± 21.09 months (median, 35 months; range, 11-96 months). Anterior segment toxicity was seen in 10 (53%) eyes and posterior segment toxicity in 5 (26%) eyes. Kaplan-Meier survival estimates for globe salvage at 2 years was 94% and 73% at 5 years. Kaplan-Meier survival for vitreous seed-free status was 94% at 2 years and 65% at 5 years. Conclusions: An expanded vitreous seed classification system that further subcategorizes hitherto unrecognized vitreous seed morphology is needed. An intermediate streaking process results in a prolonged regression time for sphere vitreous seeds.

Site-selective unidirectional benzylic sp3 C-H oxidation of dodecahydrotriphenylene with RuCl3-NaIO4: formation of benzylic ketones.

Dodecahydrotriphenylene, a higher homologue of trindane chemoselectively undergoes unidirectional benzylic sp3 C-H oxidation and the central benzene ring remains intact unlike that in trindane under similar reaction conditions. RuO4 which generally attacks sp2 C-H to form oxidative products is found to give benzylic ketones via sp3 C-H oxidation. Density functional theory (DFT) calculations have also been performed to analyse the potential energy, energy barrier and HOMO-LUMO energy gap of the products.

Effect of boric acid on poly vinyl alcohol- tannin blend and its application as water-based wood adhesive.

The work presented here focusses on developing adhesive by blending tannin and polyvinyl alcohol (PVA) in water. To furthermore enhance the properties crosslinking is carried by using boric acid at varying concentrations. Presence of free hydroxyl groups in PVA and tannin acts as a site for crosslinking reaction. The empty p orbital of trivalent boron atom attracts nucleophilic hydroxyl groups of PVA and tannin, hence are expected to form crosslinks. The interaction of boric acid with the blend was confirmed by FTIR spectra studies. The acidic pH favoured the reaction and its effects were observed by increase in viscosity and glass transition temperature (Tg). Films cased with the crosslinked blend demonstrated less hydrophilic behaviour from water contact angle test also increment in pencil hardness value and stress-bearing capacity. Adhesive performance properties like wet tack and time-dependent tensile lap shear strength on softwood and hardwood specimens were evaluated. The crosslinking-enhanced cohesion by reducing the free volumes between the chains and due to this, enhancement in tensile strength on bonded wood substrates was observed. Overall, it was found that the adhesive prepared by crosslinking PVA/tannin blend with boric acid is suitable for wood adhesive application.

CERKL mutation causing retinitis pigmentosa(RP) in Indian population - a genotype and phenotype correlation study.

BACKGROUND: Mutations in CERKL gene has been reported to cause Retinitis pigmentosa (RP) and clinically appears discrete from other commonly encountered phenotypes. We report 14 patients who were seen to have CERKL mutation of the 152 patients of RP from Indian population who underwent genetic testing. MATERIALS AND METHODS: A retrospective analysis was performed in 28 eyes of the 14 unrelated patients to establish genotype phenotype correlation. Targeted next generation sequencing was performed using the STRAND® NGS v2.5 software. Validation was done using PCR-based bidirectional Sanger sequencing. Clinical data was collected along with imaging such as fundus photo, autofluorescence(AF), Optical coherence tomography and Electroretinogram wherever available. RESULTS: Three variants c.1045_1046delAT, c.847 C > T and a novel c.899-IG>A were identified. Retinal morphological features were typically bilaterally symmetrical with mild to moderate disc pallor and arteriolar attenuation in all cases, while sparse peripheral pigmentation was noted in seven patients indicating paucipigmentary character. Early macular involvement in all cases was a characteristic finding with central hypo-autofluorescence and surrounding hyper-autofluorescence. Peripheral scalloped chorioretinal atrophic patches were seen in five patients particularly in older patients. CONCLUSIONS: Phenotype associated with CERKL mutation appears clinically discrete from other commonly encountered phenotypes of inherited retinal dystrophies. Recognizing this typical genotype phenotype correlation will help clinicians to identify this form of RP, prognosticate the disease and segregate candidates for futures gene therapy.

Thyroid dysfunction and its association with microvascular complications in patients with type 2 diabetes mellitus in south India.

BACKGROUND AND AIMS: To study the prevalence of thyroid disorders and their association with microvascular complications among adult type 2 diabetes mellitus (T2DM) patients from south-coastal Andhra Pradesh, India METHODS: This cross-sectional study included 500 subjects with T2DM and was conducted in a tertiary health care center from south-coastal Andhra Pradesh. Participants previously diagnosed with thyroid disorders were excluded from the study. RESULTS: Thyroid dysfunction was observed in 98 (19.6%) subjects of which subclinical hypothyroidism (n = 66, 13.2%) was the most common. Subclinical hypothyroidism (SCH) was more frequent in obese patients (16.2% vs 7.6%, p = 0.007) and metformin users (9.6% vs 18.7%, p = 0.0044). Diabetic retinopathy (27.3% vs 8.9%, p = 0.001) was significantly more frequent in SCH patients than euthyroid T2DM patients. CONCLUSION: Among T2DM patients from south-coastal Andhra Pradesh the prevalence of thyroid dysfunction, especially that of SCH was high; SCH was more frequent among obese and nonmetformin users and was associated was associated with increased risk of diabetic retinopathy.

Retinopathy of prematurity treatment: Asian perspectives.

Retinopathy of prematurity (ROP) is a vasoproliferative disease of developing retinal vessels that affects premature infants and can lead to severe and irreversible visual loss if left untreated. India and some other Asian countries are in the middle of a 'third ROP epidemic'. Blindness due to ROP is largely preventable if appropriate, adequate and accessible screening programmes are available. Screening of the premature babies is the first step in ROP management. With the increase in use of tele-screening techniques, more premature babies have been brought under the screening network both from urban and rural regions. Laser photocoagulation to the avascular retina using indirect ophthalmoscopy delivery system is the gold standard for ROP treatment and is usually done under topical anaesthesia in the Asian region in contrast to the western world. Use of intravitreal anti-vascular endothelial growth factors (VEGF) although controversial in management of ROP has been found to be effective in various Asian studies as well. ROP surgery in India and other middle-income Asian countries is largely performed only in few tertiary eye care centres. Poor visual prognosis, late presentation with advanced retinal detachments, lack of adequate number of trained paediatric retinal surgeons and paediatric anaesthetists also contribute to this problem. This current paper summarizes the Asian experience of ROP management.

Effect of vinyl silane modification on thermal and mechanical properties of starch-polyvinyl alcohol blend.

This study aims to observe the effect of addition of silane coupling agent on polyvinyl alcohol and starch-PVA blend. Starch and PVA blend with citric acid addition was prepared. Silane-modified polymer was obtained by treating polyvinyl alcohol and starch-PVA blend with Trimethoxyvinylsilane. The blend has been tested against the canarium wood substrate for tensile strength. A further property like viscosity has also been evaluated. Analytical tests such as DSC and DMA proved the phenomenon of cross-linking, having shown an increase in glass transition temperature and area under the curve of tan delta. The efficient and novel method for polymerization of vinyl groups present in the PVA and PVA-starch blends has contributed to better adhesion on the wood substrate and also better cohesion between the chains.

Effect of glutaraldehyde on thermal and mechanical properties of starch and polyvinyl alcohol blends.

The aim of this study is to analyze the various compositions of polyvinyl alcohol (PVA) and starch (S) blends. The blends have been cross-linked with glutaraldehyde to enhance its properties. The hydroxyl groups of PVA and starch react with glutaraldehyde via formation of acetal bonds hence crosslinking could take place. The cross-linking of glutaraldehyde is observed with the help of various analytical methods such as differential scanning calorimetry (DSC) and Fourier-transform infrared spectroscopy (FTIR). The presence of two highly reactive alpha protons makes glutaraldehyde more reactive and acidic in nature. The higher reactivity of glutaraldehyde, at higher dosages leads to reduction in H-bonding of PVA and starch. The cross-linked blends showed better thermal and mechanical properties. Viscosity, tensile strength, pencil hardness, and ultimate stress were evaluated to estimate the changes due to cross-linking. It was observed that the mechanical properties are directly proportional to the amount of starch as the starch hydroxyl groups are easily accessible for the cross-linking reaction. The cross-linked blend showed better cohesion between its chains, thereby increasing the glass transition temperature. It was reflected in the subsequent increase in tensile strength properties.

Insulin resistance and hyperandrogenemia independently predict nonalcoholic fatty liver disease in women with polycystic ovary syndrome.

AIMS: To find the prevalence and predictors of nonalcoholic fatty liver disease (NAFLD) in Asian Indian polycystic ovary syndrome (PCOS) women. MATERIALS AND METHODS: This is a prospective, cross-sectional study conducted at a tertiary care hospital from South India. Sixty women fulfilling the Rotterdam (2003) criteria for PCOS were recruited for the study. All participants were evaluated with ultrasound abdomen for fatty liver and additional biochemical investigations including fasting plasma glucose, postprandial plasma glucose, serum insulin, lipid profile and liver function tests. RESULTS: The mean age of the study population was 24.06 ±â€¯5.9 (range: 15-39) years. Oligomenorrhea, hirsutism and acne were present in 58 (96.7%), 37 (61.7%) and 33 (55%) women. Mean BMI of the study population was 29.5 ±â€¯5.28 (range: 19.95 to 45.44) kg/m2. Fifty (83.3%) women were obese (BMI: ≥ 25 kg/m2). Twenty-three (38.3%) women with PCOS had NAFLD. Three women each had isolated elevation of alanine transaminase (ALT) and aspartate transaminases (AST) whereas three women had elevation of both. All women with elevated transaminases had NAFLD. By univariate analysis, factors associated with NAFLD were serum total cholesterol, serum insulin, HOMA-IR, hyperandrogenism, ALT and AST. On multiple regression analysis using linear regression, HOMA-IR and hyperandrogenemia were the only significant predictors of NAFLD. CONCLUSION: Our study reports NAFLD in more than one third of Asian Indian women with PCOS. In addition to insulin resistance (HOMA-IR), hyperandrogenemia is an independent predictor of NAFLD in women with PCOS.

Utility of a Commercially Available Blood Steroid Profile in Endocrine Practice.

BACKGROUND: A blood steroid profile has recently become available on commercial basis in India. In this study, we report our initial experience with the use of steroid profile in the evaluation of disorders of sex development (DSD) and suspected cases of congenital adrenal hyperplasia (CAH) and discuss the potential scenarios in endocrine practice that may benefit from this steroid profile. MATERIALS AND METHODS: The study included six subjects. Patient 1 was a 46, XX girl who presented with peripubertal virilization, patient 2 was a girl who presented with normal pubertal development, secondary amenorrhea, and virilization, and patient 3 was a girl who presented with primary amenorrhea and virilization. These three patients were suspected to have CAH but had non-diagnostic serum 17 OH-progesterone levels. Patient 4 and 5 were 46, XY reared as girls who presented with primary amenorrhea alone and primary amenorrhea and virilization, respectively, and sixth subject was a heathy volunteer. All subjects were evaluated with blood steroid profile by Liquid chromatography tandem mass spectrometry (LC-MS/MS). RESULTS: Patient 1 and 2 were diagnosed to have 11 ß-hydroxylase deficiency by using the steroid profile. Patient 3 was suspected to have CAH, but the steroid profile excluded the diagnosis and helped to confirm the diagnosis as polycystic ovary syndrome. In patient 4 and patient 5, although steroid profile ruled out the possibility of steroidogenesis defects, it did not help to reach at the specific diagnosis. CONCLUSION: The blood steroid profile used in this study is most useful for the diagnosis of 11 ß-hydroxylase deficiency. The utility of this test is limited in the evaluation of 46, XY patients with under-virilization.

Is Freehand Technique of Pedicle Screw Insertion in Thoracolumbar Spine Safe and Accurate? Assessment of 250 Screws.

BACKGROUND: Pedicle screw fixation is one of the widely used procedures for instrumentation and stabilization of the thoracic and lumbar spine. It has the advantage of stabilizing all the three columns in single approach. Various assistive techniques are available to place the pedicle screws more accurately but at the expense of increased exposure to radiation, prolonged surgical duration, and cost. OBJECTIVE: The objective of this study is to determine the accuracy and safety of pedicle screw fixation in the thoracolumbar spine using freehand surgical technique. MATERIALS AND METHODS: We evaluated all patients who underwent pedicle screw fixation of the thoracolumbar spine for various ailments at our institute from January 2016 to December 2017 with postoperative computed tomography scan for placement accuracy. We used Gertzbein classification to grade pedicle breaches. Screw penetration more than 4 mm was taken as critical and those less than that were classified as noncritical. RESULTS: A total of 256 screws inserted in T1-L5 vertebrae were included from 40 consecutive patients. Six screws were excluded according to selection criteria. The mean age was 39 years. Trauma (36 patients) was the common reason for which the pedicle screw fixation was done followed by degenerative disease (2 patients) and tumour (2 patients). A total of ten pedicle screw breaches (4%) were identified in eight patients. Among these, three critical breaches (1.2%) were occurred in two patients which required revision. The remaining seven breaches were noncritical and kept under close observation and follow-up. CONCLUSION: Pedicle screw had become the workhorse of posterior stabilization of the spine. Based on external anatomy and landmarks alone, freehand technique for pedicle screw fixation can be performed with acceptable safety and accuracy avoiding cumulative radiation exposure and prolonged operative time.

UPLC and ESI-MS analysis of metabolites of Rauvolfia tetraphylla L. and their spatial localization using desorption electrospray ionization (DESI) mass spectrometric imaging.

Rauvolfia tetraphylla L. (family Apocynaceae), often referred to as the wild snakeroot plant, is an important medicinal plant and produces a number of indole alkaloids in its seeds and roots. The plant is often used as a substitute for Ravuolfia serpentine (L.) Benth. ex Kurz known commonly as the Indian snakeroot plant or sarphagandha in the preparation of Ayurvedic formulations for a range of diseases including hypertension. In this study, we examine the spatial localization of the various indole alkaloids in developing fruits and plants of R. tetraphylla using desorption electrospray ionization mass spectrometry imaging (DESI-MSI). A semi-quantitative analysis of the various indole alkaloids was performed using UPLC-ESI/MS. DESI-MS images showed that the distribution of ajmalcine, yohimbine, demethyl serpentine and mitoridine are largely localized in the fruit coat while that for ajmaline is restricted to mesocarp of the fruit. At a whole plant level, the ESI-MS intensities of many of the ions were highest in the roots and lesser in the shoot region. Within the root tissue, except sarpagine and ajmalcine, all other indole alkaloids occurred in the epidermal and cortex tissues. In leaves, only serpentine, ajmalcine, reserpiline and yohimbine were present. Serpentine was restricted to the petiolar region of leaves. Principal component analysis based on the presence of the indole alkaloids, clearly separated the four tissues (stem, leaves, root and fruits) into distinct clusters. In summary, the DESI-MSI results indicated a clear tissue localization of the various indole alkaloids, in fruits, leaves and roots of R. tetraphylla. While it is not clear of how such localization is attained, we discuss the possible pathways of indole alkaloid biosynthesis and translocation during fruit and seedling development in R. tetraphylla. We also briefly discuss the functional significance of the spatial patterns in distribution of metabolites.

Predictors of Three-month Hospital Readmissions and Mortality in Patients with Cirrhosis of Liver.

BACKGROUND: The rate of readmission to the hospital and mortality within 3 months is used as a quality measure for hospitalized patients with advanced liver disease; however, the topic has not been studied adequately under Indian context. MATERIALS AND METHODS: This study was a longitudinal study conducted from March 2017 to March 2018. Patients admitted with liver cirrhosis at inpatient hepatology service in Tertiary Health Care Centre, Mysore, India, were included for the study. A total of 232 patients were studied and their demographic, clinical, biochemical parameters along with readmission status and outcomes within 3 months of observation were recorded. The effect of these factors on readmission and mortality was studied through multivariate logistic regression. RESULTS: The risk of readmission within 3 months was significantly associated with the presence of hydrothorax, hepatorenal syndrome (HRS), and portal vein thrombosis (PVT). Maddrey's discriminant function (DF), model for end-stage liver disease (MELD) score, and the Child-Turcotte-Pugh (CTP) C grade also significantly increased the odds of readmission. The area under curve (AUC) for DF and MELD were 0.927 and 0.928, respectively. Both DF and MELD significantly increased the odds of mortality. CONCLUSION: The present study revealed that the parameters such as MELD and DF score and complications such as hydrothorax, HRS, and PVT are the most predictive indicators of cirrhosis complication to ascertain the rate of readmission and mortality within 3 months of patient discharge. HOW TO CITE THIS ARTICLE: Lavekar A, Raje D, Sadar A, et al. Predictors of Three-month Hospital Readmissions and Mortality in Patients with Cirrhosis of Liver. Euroasian J Hepato-Gastroenterol 2019;9(2):71-77.