Sadaf Khan - Academia.edu (original) (raw)

Papers by Sadaf Khan

ABSTRACT Metrology is the science and art of precision measurement, testing and evaluation. It ha... more ABSTRACT Metrology is the science and art of precision measurement, testing and evaluation. It has a vital role in technological development. In this paper, a Non-contact metrology based new technique is proposed to automatically distinguish the qualified and unqualified capsules manufactured in the pharmaceutical industry based on image processing technique. The existing algorithms for the same purpose are work on the principle of pixel to pixelcomparison with a fixed window size of neighborhood. When the image is scaled or translated, the pixel to pixel comparison is difficult to achieve. A small effort is, therefore, made to solve this problem using a new technique for automatic window size determination. Gaussian filter is applied for smoothing and non-linear filter is applied for re-smoothing as a preprocessing step. In addition, edges are detected by canny edge detector and Gabor energy filters. Results obtained reveal that the proposed technique for automatic window size determination is a good and efficient solution with the use of Hausdroff distance, through which a binary comparison is performed after segmentation and thresholding.

Planta, 2007

Auxins regulate a complex signal transduction network to direct plant development. Auxin-responsi... more Auxins regulate a complex signal transduction network to direct plant development. Auxin-responsive genes fit into three major classes: the so-called auxin/indole-3-acetic acid (Aux/IAA), the GH3, and the small auxinup RNA (SAUR) gene families. The 20-member Arabidopsis thaliana GH3 gene family has been subdivided into three groups. In vitro studies have shown that most Group II members function as IAA-amido synthetases to conjugate amino acids to the plant hormone auxin. Here we report the role of a previously uncharacterized GH3 gene family member, GH3.9, in root growth. Unlike most other Group II family members, GH3.9 expression was repressed by low concentrations of exogenous IAA in seedlings. Transgenic plants harboring a GH3.9 promoter::reporter gene construct indicate that GH3.9 is expressed in the root-hypocotyl junction, leaves and the shoot apical meristem of young seedlings, in mature embryos, and in the root vascular tissue. Expression was also observed in lateral root tips when seedlings were treated with exogenous IAA. Inverse PCR was used to identify an activation tagged T-DNA insertion in chromosome 2 near the 5′UTR region of At2g47750 (GH3.9). Plants homozygous for the T-DNA insertion (gh3.9-1 mutants) had reduced GH3.9 expression, no obvious effects on apical dominance or leaf morphology, greater primary root length, and increased sensitivity to indole-3-acetic acid (IAA)-mediated root growth inhibition. Additional T-DNA insertion alleles and transgenic plants with reduced GH3.9 transcript levels due to RNA-interference (RNAi) also showed these same phe-notypes. Our results provide new information on the function of GH3.9 in roots where it is likely to control auxin activity through amino acid conjugation.

Plant signaling & behavior, 2007

Journal of plant physiology, Jan 15, 2010

Calcium (Ca(2+))-dependent/activated proteases make decisive cleavages in proteins, affecting the... more Calcium (Ca(2+))-dependent/activated proteases make decisive cleavages in proteins, affecting their further degradation/activation. Few such Ca(2+)-dependent proteases have been reported from plants, and none during germination-related events. Seeds are woken up from their quiescent state upon imbibition of water. The subsequent process of germination is strongly influenced by hormones (mainly gibberellins) and light, with both resulting in change in intracellular Ca(2+). We have investigated the effect of Ca(2+) on protease activity in extracts prepared from dry Vigna radiata (L.) Wilczec seeds and cotyledons 4, 24, 48 and 72h post-imbibition. Ca(2+)-activated protease activity is present at a very low level in dry seeds, rises with imbibition and peaks 24h post-imbibition. Subsequently, the activity rapidly declines, even as total protease activity continues to rise. Calcium activation of proteolysis was reversed by ethylene diamine tetraacetic acid (EDTA), ethylene glycol-bis (2-aminoethylether)-N,N,N',N'-tetraacetic acid (EGTA), 1,10, phenanthroline, chlorpromazine and by beta-mercaptoethanol in a concentration-dependent manner. Protease activity was also inhibited by para chloro mercuribenzoate (pCMB) and l-trans-epoxysuccinyl-leucylamido(4-guanidino) butane (E 64), while phenyl methyl sulfonyl fluoride (PMSF) and pepstatin did not effect Ca(2+) activation. The protease could be separated from the calmodulin fraction by size-exclusion chromatography, while retaining its ability for Ca(2+) activation, excluding the possibility of activation through calmodulin-based pathways. The presence of a Ca(2+)-activated protease in the cotyledons suggests its role in a predetermined program of germination involving elevation of cytosolic Ca(2+) levels during germination. This protease could be an important enzyme interfacing cytoplasmic signaling events and initiation of storage protein mobilization during seed germination.

BMC plant biology, 2010

Background: The plant circadian clock orchestrates 24-hour rhythms in internal physiological proc... more Background: The plant circadian clock orchestrates 24-hour rhythms in internal physiological processes to coordinate these activities with daily and seasonal changes in the environment. The circadian clock has a profound impact on many aspects of plant growth and development, including biomass accumulation and flowering time. Despite recent advances in understanding the circadian system of the model plant Arabidopsis thaliana, the contribution of the circadian oscillator to important agronomic traits in Zea mays and other cereals remains poorly defined. To address this deficit, this study investigated the transcriptional landscape of the maize circadian system.

Journal of human lactation : official journal of International Lactation Consultant Association, 2013

Several factors are known to affect breast milk composition; however, little information is avail... more Several factors are known to affect breast milk composition; however, little information is available regarding the week-toweek variations in breast milk macronutrient content during established lactation.

The primary care companion for CNS disorders, 2013

Clinics in colon and rectal surgery, 2013

Despite its short history, surgical simulation has been successfully introduced into surgical res... more Despite its short history, surgical simulation has been successfully introduced into surgical residency programs in an effort to augment training. A wide range of simulator types and levels of complexity have proven an effective teaching method for surgical trainees. They have been used for training in areas such as general surgery, urology, gynecology, and ophthalmology among others. Coincident with the introduction of simulators is the need for objective evaluation of skills learned on them, which has led to the development and validation of multiple evaluation tools. This article evaluates the drivers for simulation, types of simulators, training, and evaluation of them especially as it pertains to laparoscopic colorectal surgery.

American journal of surgery, 2014

Our objective was to evaluate ileostomy reversal patients managed with a standardized enhanced re... more Our objective was to evaluate ileostomy reversal patients managed with a standardized enhanced recovery pathway to identify factors associated with readmissions. Prospective review database identified ileostomy reversal patients. Variables for the index admission and readmission were evaluated. Three hundred thirty-two patients were analyzed. The primary diagnosis was colorectal cancer (57.6%). Thirteen percent of the patients were discharged by postoperative day (POD) 1, 47% by POD 2, and 65% by POD 3. The complication rate was 16.8%. The main complication was ileus/small bowel obstruction (n = 27). Thirty-day readmission rate was 12.4% (n = 41); small bowel obstruction (n = 27) was the most frequent readmission diagnosis. The median readmission POD was 7. Only 1 patient had a follow-up visit before readmission. The median readmission length of stay was 4 days. Most ileostomy reversal readmissions occur before the first follow-up and stem from preventable causes. An enhanced recovery pathway modification may improve outcomes and utilization in this group.

Pediatric dentistry

The purpose of this paper was to describe a rare case of idiopathic coronal resorption of an uner... more The purpose of this paper was to describe a rare case of idiopathic coronal resorption of an unerupted permanent mandibular second molar, which was detected as a chance finding on an orthopantomogram taken to assess dental eruption on a young patient about to start orthodontic treatment. The affected tooth was removed and underwent histopathological investigation. This case report provides a discussion of the possible etiologies for this radiographic appearance, as well as the diagnosis and management of such lesions. Failure to identify such lesions can potentiate a guarded prognosis. Further research is required in this field to investigate the etiology and pathological process, albeit this is limited by the rarity if these lesions.

Stewart Postharvest Review, 2013

Faculty Dental Journal, 2011

ABSTRACT What will the future hold? On graduating from dental school, you are faced with endless ... more ABSTRACT What will the future hold? On graduating from dental school, you are faced with endless possibilities with regards to the direction of your career. You may decide to concentrate on a career in general dental practice or you may find that certain areas of dentistry interest you more than others. This article looks at the specialty of orthodontics and what you would need to do if you wished to become an orthodontist.

Background: Elevated plasma homocysteine is a known risk factor for atherosclerotic vascular dise... more Background: Elevated plasma homocysteine is a known risk factor for atherosclerotic vascular disease. In fact, it is an independent risk factor similar to smoking or hyperlipidemia but it is under recognized among the doctors of Pakistan. An elevated homocysteine level induces thrombogenicity, causes procoagulant state and promotes the proliferation of smooth muscle cells. This study was carried out to find out the serum homocysteine levels in patients with known hypertension. Methods: One hundred patients more than 60 years of age of both the sexes with documented hypertension were selected from medical wards and cardiology ward of Civil Hospital Karachi. Study subjects had no history of atherosclerotic disease or diabetes mellitus. Homocysteine estimation was done by FPIA method on IMX. Results: It was seen that 80% patients selected had an elevated homocysteine levels (18.77±1.9 as against 5-15 taken as normal). Conclusion: We have observed that serum homocysteine is raised in most of the patients with hypertension.

Materials Science-Poland, 2014

Graphene, a single atom thick sheet is considered a key candidate for the future nanotechnology, ... more Graphene, a single atom thick sheet is considered a key candidate for the future nanotechnology, due to its unique extraordinary properties. Researchers are trying to synthesize bulk graphene via chemical route from graphene oxide precursor. In the present work, we investigated a safe and efficient way of monolayer graphene oxide synthesis. To get a high degree of oxidation, we sonicated the graphite flakes before oxidation. X-ray diffraction (XRD) and Fourier transform infrared spectroscopy (FTIR) results confirmed graphene oxide formation and high degree of oxidation. Raman spectroscopy and atomic force microscopy (AFM) results revealed a monolayer of graphene oxide (GO) flakes. The sheet like morphology of the GO flakes was further confirmed by scanning electron microscopy (SEM). The Hall effect measurements were performed on the GO film on a silica substrate to investigate its electrical properties. The results obtained, revealed that the GO film is perfectly insulating, having electrical resistivity up to 8.4 × 10 8 (Ω·cm) at room temperature.

The Primary Care Companion For CNS Disorders, 2012

Jurnal Teknologi, 2013

Dysfunctional audit behaviors behind corporate fiascos are a burning issue in today's ever changi... more Dysfunctional audit behaviors behind corporate fiascos are a burning issue in today's ever changing globalized business world. After the Enron scandal that saw the demise of Arthur Andersen LLP., a growing research interest in the field of audit quality is being witnessed. With this negative publicity of professional auditing firms, it is pertinent to execute an efficient audit, causes of these dysfunctional audit behaviors should necessarily be identified and eliminated. To help address this issue, the paper attempted to explain an auditor's behavioral intention to engage or not to engage in dysfunctional audit behaviors through the lens of the Theory of Reasoned Action. The study proposed a Theory of Reasoned Action as a guide for a valid prediction of auditors's intention to involve in dysfunctional audit behaviors. This proposed framework is recommended for not only practitioners who engaged in the auditing profession, but also for many other regulators including the board of directors, audit committees, top management, stakeholder, and governing bodies, to enable them take initiatives to enhance the ethics in their work environments.

Surgical Endoscopy, 2014

Unplanned readmissions after colorectal surgery impact patient and financial outcomes. Our goal w... more Unplanned readmissions after colorectal surgery impact patient and financial outcomes. Our goal was to identify factors related to readmission in ostomy reversal patients. Review of a prospective department database was performed from 2006 to 2012 to identify patients who underwent an ostomy reversal. Patients were stratified into nonreadmitted and readmitted within 30 days of ostomy reversal. The main outcome measures were predictors of readmission and characteristics of patients readmitted and not readmitted. A total of 351 ostomy reversals (86 % ileostomy and 14 % colostomy) were analyzed; 44 patients were readmitted (12.5 %). Readmitted and nonreadmitted patients were similar in age, body mass index, gender, comorbidities, indications for the index operation, and time to ostomy reversal. Readmitted patients had longer operative times (p = 0.002) and length of stay (p = 0.001), more intraoperative blood loss (p = 0.003), intraoperative complications (p = 0.005), ICU requirements (p < 0.0001), need for temporary nursing at discharge (p < 0.001), and higher total hospital costs than nonreadmitted patients (p = 0.0162). Longer operative time [odds ratio (OR) 1.006, 95 % confidence interval (CI) 1.001-1.012], intraoperative complications (OR 7.334, 95 % CI 1.23-43.761), ICU stay (OR 1.291, 95 % CI 1.18-1.893), delayed discharge (OR 1.085, 95 % CI 1.003-1.173), and discharge to skilled nursing facility (OR 6.936, 95 % CI 1.531-31.332) were independent predictors of readmission. Ostomy type had no independent effect on readmission. Differences in perioperative and outcomes variables exist between readmitted and nonreadmitted patients after ostomy reversal. Longer operative times, intraoperative complications, intensive care unit care, longer length of stay, and skilled nursing at discharge were independently predictive of readmission. These findings can be used to identify high-risk patients prospectively, potentially improving clinical outcomes and healthcare utilization.

Saudi Journal of Gastroenterology, 2010

Congenital internal hernia is a rare cause of bowel obstruction in adults and often presents with... more Congenital internal hernia is a rare cause of bowel obstruction in adults and often presents with complications. A high index of suspicion, occasionally aided by appropriate radiological imaging, should lead to early surgical intervention and thus reduce morbidity and mortality. We describe a case of a 27-yearold woman who presented with upper abdominal pain and nonspecifi c abdominal signs. Computed tomography showed features of bowel ischemia which prompted surgical intervention. On exploration, she was found to have a large mesenteric defect with herniating ileum and ascending colon. A segment of gangrenous small bowel was resected. The mesenteric defect was repaired and the bowel tacked down to prevent volvulus. The patient made an uneventful recovery.

ABSTRACT Metrology is the science and art of precision measurement, testing and evaluation. It ha... more ABSTRACT Metrology is the science and art of precision measurement, testing and evaluation. It has a vital role in technological development. In this paper, a Non-contact metrology based new technique is proposed to automatically distinguish the qualified and unqualified capsules manufactured in the pharmaceutical industry based on image processing technique. The existing algorithms for the same purpose are work on the principle of pixel to pixelcomparison with a fixed window size of neighborhood. When the image is scaled or translated, the pixel to pixel comparison is difficult to achieve. A small effort is, therefore, made to solve this problem using a new technique for automatic window size determination. Gaussian filter is applied for smoothing and non-linear filter is applied for re-smoothing as a preprocessing step. In addition, edges are detected by canny edge detector and Gabor energy filters. Results obtained reveal that the proposed technique for automatic window size determination is a good and efficient solution with the use of Hausdroff distance, through which a binary comparison is performed after segmentation and thresholding.

Planta, 2007

Auxins regulate a complex signal transduction network to direct plant development. Auxin-responsi... more Auxins regulate a complex signal transduction network to direct plant development. Auxin-responsive genes fit into three major classes: the so-called auxin/indole-3-acetic acid (Aux/IAA), the GH3, and the small auxinup RNA (SAUR) gene families. The 20-member Arabidopsis thaliana GH3 gene family has been subdivided into three groups. In vitro studies have shown that most Group II members function as IAA-amido synthetases to conjugate amino acids to the plant hormone auxin. Here we report the role of a previously uncharacterized GH3 gene family member, GH3.9, in root growth. Unlike most other Group II family members, GH3.9 expression was repressed by low concentrations of exogenous IAA in seedlings. Transgenic plants harboring a GH3.9 promoter::reporter gene construct indicate that GH3.9 is expressed in the root-hypocotyl junction, leaves and the shoot apical meristem of young seedlings, in mature embryos, and in the root vascular tissue. Expression was also observed in lateral root tips when seedlings were treated with exogenous IAA. Inverse PCR was used to identify an activation tagged T-DNA insertion in chromosome 2 near the 5′UTR region of At2g47750 (GH3.9). Plants homozygous for the T-DNA insertion (gh3.9-1 mutants) had reduced GH3.9 expression, no obvious effects on apical dominance or leaf morphology, greater primary root length, and increased sensitivity to indole-3-acetic acid (IAA)-mediated root growth inhibition. Additional T-DNA insertion alleles and transgenic plants with reduced GH3.9 transcript levels due to RNA-interference (RNAi) also showed these same phe-notypes. Our results provide new information on the function of GH3.9 in roots where it is likely to control auxin activity through amino acid conjugation.

Plant signaling & behavior, 2007

Journal of plant physiology, Jan 15, 2010

Calcium (Ca(2+))-dependent/activated proteases make decisive cleavages in proteins, affecting the... more Calcium (Ca(2+))-dependent/activated proteases make decisive cleavages in proteins, affecting their further degradation/activation. Few such Ca(2+)-dependent proteases have been reported from plants, and none during germination-related events. Seeds are woken up from their quiescent state upon imbibition of water. The subsequent process of germination is strongly influenced by hormones (mainly gibberellins) and light, with both resulting in change in intracellular Ca(2+). We have investigated the effect of Ca(2+) on protease activity in extracts prepared from dry Vigna radiata (L.) Wilczec seeds and cotyledons 4, 24, 48 and 72h post-imbibition. Ca(2+)-activated protease activity is present at a very low level in dry seeds, rises with imbibition and peaks 24h post-imbibition. Subsequently, the activity rapidly declines, even as total protease activity continues to rise. Calcium activation of proteolysis was reversed by ethylene diamine tetraacetic acid (EDTA), ethylene glycol-bis (2-aminoethylether)-N,N,N',N'-tetraacetic acid (EGTA), 1,10, phenanthroline, chlorpromazine and by beta-mercaptoethanol in a concentration-dependent manner. Protease activity was also inhibited by para chloro mercuribenzoate (pCMB) and l-trans-epoxysuccinyl-leucylamido(4-guanidino) butane (E 64), while phenyl methyl sulfonyl fluoride (PMSF) and pepstatin did not effect Ca(2+) activation. The protease could be separated from the calmodulin fraction by size-exclusion chromatography, while retaining its ability for Ca(2+) activation, excluding the possibility of activation through calmodulin-based pathways. The presence of a Ca(2+)-activated protease in the cotyledons suggests its role in a predetermined program of germination involving elevation of cytosolic Ca(2+) levels during germination. This protease could be an important enzyme interfacing cytoplasmic signaling events and initiation of storage protein mobilization during seed germination.

BMC plant biology, 2010

Background: The plant circadian clock orchestrates 24-hour rhythms in internal physiological proc... more Background: The plant circadian clock orchestrates 24-hour rhythms in internal physiological processes to coordinate these activities with daily and seasonal changes in the environment. The circadian clock has a profound impact on many aspects of plant growth and development, including biomass accumulation and flowering time. Despite recent advances in understanding the circadian system of the model plant Arabidopsis thaliana, the contribution of the circadian oscillator to important agronomic traits in Zea mays and other cereals remains poorly defined. To address this deficit, this study investigated the transcriptional landscape of the maize circadian system.

Journal of human lactation : official journal of International Lactation Consultant Association, 2013

Several factors are known to affect breast milk composition; however, little information is avail... more Several factors are known to affect breast milk composition; however, little information is available regarding the week-toweek variations in breast milk macronutrient content during established lactation.

The primary care companion for CNS disorders, 2013

Clinics in colon and rectal surgery, 2013

Despite its short history, surgical simulation has been successfully introduced into surgical res... more Despite its short history, surgical simulation has been successfully introduced into surgical residency programs in an effort to augment training. A wide range of simulator types and levels of complexity have proven an effective teaching method for surgical trainees. They have been used for training in areas such as general surgery, urology, gynecology, and ophthalmology among others. Coincident with the introduction of simulators is the need for objective evaluation of skills learned on them, which has led to the development and validation of multiple evaluation tools. This article evaluates the drivers for simulation, types of simulators, training, and evaluation of them especially as it pertains to laparoscopic colorectal surgery.

American journal of surgery, 2014

Our objective was to evaluate ileostomy reversal patients managed with a standardized enhanced re... more Our objective was to evaluate ileostomy reversal patients managed with a standardized enhanced recovery pathway to identify factors associated with readmissions. Prospective review database identified ileostomy reversal patients. Variables for the index admission and readmission were evaluated. Three hundred thirty-two patients were analyzed. The primary diagnosis was colorectal cancer (57.6%). Thirteen percent of the patients were discharged by postoperative day (POD) 1, 47% by POD 2, and 65% by POD 3. The complication rate was 16.8%. The main complication was ileus/small bowel obstruction (n = 27). Thirty-day readmission rate was 12.4% (n = 41); small bowel obstruction (n = 27) was the most frequent readmission diagnosis. The median readmission POD was 7. Only 1 patient had a follow-up visit before readmission. The median readmission length of stay was 4 days. Most ileostomy reversal readmissions occur before the first follow-up and stem from preventable causes. An enhanced recovery pathway modification may improve outcomes and utilization in this group.

Pediatric dentistry

The purpose of this paper was to describe a rare case of idiopathic coronal resorption of an uner... more The purpose of this paper was to describe a rare case of idiopathic coronal resorption of an unerupted permanent mandibular second molar, which was detected as a chance finding on an orthopantomogram taken to assess dental eruption on a young patient about to start orthodontic treatment. The affected tooth was removed and underwent histopathological investigation. This case report provides a discussion of the possible etiologies for this radiographic appearance, as well as the diagnosis and management of such lesions. Failure to identify such lesions can potentiate a guarded prognosis. Further research is required in this field to investigate the etiology and pathological process, albeit this is limited by the rarity if these lesions.

Stewart Postharvest Review, 2013

Faculty Dental Journal, 2011

ABSTRACT What will the future hold? On graduating from dental school, you are faced with endless ... more ABSTRACT What will the future hold? On graduating from dental school, you are faced with endless possibilities with regards to the direction of your career. You may decide to concentrate on a career in general dental practice or you may find that certain areas of dentistry interest you more than others. This article looks at the specialty of orthodontics and what you would need to do if you wished to become an orthodontist.

Background: Elevated plasma homocysteine is a known risk factor for atherosclerotic vascular dise... more Background: Elevated plasma homocysteine is a known risk factor for atherosclerotic vascular disease. In fact, it is an independent risk factor similar to smoking or hyperlipidemia but it is under recognized among the doctors of Pakistan. An elevated homocysteine level induces thrombogenicity, causes procoagulant state and promotes the proliferation of smooth muscle cells. This study was carried out to find out the serum homocysteine levels in patients with known hypertension. Methods: One hundred patients more than 60 years of age of both the sexes with documented hypertension were selected from medical wards and cardiology ward of Civil Hospital Karachi. Study subjects had no history of atherosclerotic disease or diabetes mellitus. Homocysteine estimation was done by FPIA method on IMX. Results: It was seen that 80% patients selected had an elevated homocysteine levels (18.77±1.9 as against 5-15 taken as normal). Conclusion: We have observed that serum homocysteine is raised in most of the patients with hypertension.

Materials Science-Poland, 2014

Graphene, a single atom thick sheet is considered a key candidate for the future nanotechnology, ... more Graphene, a single atom thick sheet is considered a key candidate for the future nanotechnology, due to its unique extraordinary properties. Researchers are trying to synthesize bulk graphene via chemical route from graphene oxide precursor. In the present work, we investigated a safe and efficient way of monolayer graphene oxide synthesis. To get a high degree of oxidation, we sonicated the graphite flakes before oxidation. X-ray diffraction (XRD) and Fourier transform infrared spectroscopy (FTIR) results confirmed graphene oxide formation and high degree of oxidation. Raman spectroscopy and atomic force microscopy (AFM) results revealed a monolayer of graphene oxide (GO) flakes. The sheet like morphology of the GO flakes was further confirmed by scanning electron microscopy (SEM). The Hall effect measurements were performed on the GO film on a silica substrate to investigate its electrical properties. The results obtained, revealed that the GO film is perfectly insulating, having electrical resistivity up to 8.4 × 10 8 (Ω·cm) at room temperature.

The Primary Care Companion For CNS Disorders, 2012

Jurnal Teknologi, 2013

Dysfunctional audit behaviors behind corporate fiascos are a burning issue in today's ever changi... more Dysfunctional audit behaviors behind corporate fiascos are a burning issue in today's ever changing globalized business world. After the Enron scandal that saw the demise of Arthur Andersen LLP., a growing research interest in the field of audit quality is being witnessed. With this negative publicity of professional auditing firms, it is pertinent to execute an efficient audit, causes of these dysfunctional audit behaviors should necessarily be identified and eliminated. To help address this issue, the paper attempted to explain an auditor's behavioral intention to engage or not to engage in dysfunctional audit behaviors through the lens of the Theory of Reasoned Action. The study proposed a Theory of Reasoned Action as a guide for a valid prediction of auditors's intention to involve in dysfunctional audit behaviors. This proposed framework is recommended for not only practitioners who engaged in the auditing profession, but also for many other regulators including the board of directors, audit committees, top management, stakeholder, and governing bodies, to enable them take initiatives to enhance the ethics in their work environments.

Surgical Endoscopy, 2014

Unplanned readmissions after colorectal surgery impact patient and financial outcomes. Our goal w... more Unplanned readmissions after colorectal surgery impact patient and financial outcomes. Our goal was to identify factors related to readmission in ostomy reversal patients. Review of a prospective department database was performed from 2006 to 2012 to identify patients who underwent an ostomy reversal. Patients were stratified into nonreadmitted and readmitted within 30 days of ostomy reversal. The main outcome measures were predictors of readmission and characteristics of patients readmitted and not readmitted. A total of 351 ostomy reversals (86 % ileostomy and 14 % colostomy) were analyzed; 44 patients were readmitted (12.5 %). Readmitted and nonreadmitted patients were similar in age, body mass index, gender, comorbidities, indications for the index operation, and time to ostomy reversal. Readmitted patients had longer operative times (p = 0.002) and length of stay (p = 0.001), more intraoperative blood loss (p = 0.003), intraoperative complications (p = 0.005), ICU requirements (p < 0.0001), need for temporary nursing at discharge (p < 0.001), and higher total hospital costs than nonreadmitted patients (p = 0.0162). Longer operative time [odds ratio (OR) 1.006, 95 % confidence interval (CI) 1.001-1.012], intraoperative complications (OR 7.334, 95 % CI 1.23-43.761), ICU stay (OR 1.291, 95 % CI 1.18-1.893), delayed discharge (OR 1.085, 95 % CI 1.003-1.173), and discharge to skilled nursing facility (OR 6.936, 95 % CI 1.531-31.332) were independent predictors of readmission. Ostomy type had no independent effect on readmission. Differences in perioperative and outcomes variables exist between readmitted and nonreadmitted patients after ostomy reversal. Longer operative times, intraoperative complications, intensive care unit care, longer length of stay, and skilled nursing at discharge were independently predictive of readmission. These findings can be used to identify high-risk patients prospectively, potentially improving clinical outcomes and healthcare utilization.

Saudi Journal of Gastroenterology, 2010

Congenital internal hernia is a rare cause of bowel obstruction in adults and often presents with... more Congenital internal hernia is a rare cause of bowel obstruction in adults and often presents with complications. A high index of suspicion, occasionally aided by appropriate radiological imaging, should lead to early surgical intervention and thus reduce morbidity and mortality. We describe a case of a 27-yearold woman who presented with upper abdominal pain and nonspecifi c abdominal signs. Computed tomography showed features of bowel ischemia which prompted surgical intervention. On exploration, she was found to have a large mesenteric defect with herniating ileum and ascending colon. A segment of gangrenous small bowel was resected. The mesenteric defect was repaired and the bowel tacked down to prevent volvulus. The patient made an uneventful recovery.