Background: Kimura’s diamond shaped duodeno-duodenostomy (DSD) is a well-recognized treatment for the management of duodenal atresia. Purpose: The aim of this study is to determine and share the experience of diamond shaped duodeno-duodenostomy and an overview of the benefits of this procedure. Place and Duration: In the Pediatric Surgery department of Govt. Sardar Begum Teaching Hospital Sialkot and Bacha Khan Medical Complex Swabi for five and half years from January 2016 to November 2021. METHODS: 42 neonates were surgically treated for duodenal atresia by Kimura’s technique. The transverse incision was given in the proximal dilated duodenum and longitudinal incision was given in the distal part of duodenum. Results: On 5th to 8 th day post-operatively, oral feeding was started (mean 6.2 days), full oral feeds were commenced between 7th to10th day (mean 9.2), peripheral intravenous fluids were discontinued 7th day to 10th day (mean 9.2), and hospital stay varies from 7th to 21st day (mean 10.8). The complications such as anastomosis leakage 1(2.4), infection 1(2.4), abnormal duodenal morphology 6(14.2) and Gastroesophageal reflux in 2(4.8) of patients. In prenatal ultrasonography of the fetus, obstruction of the duodenum was diagnosed in 31/42 (73.9%) and polyhydramnios in 19/42 (45.2%) cases. Conclusion: DSD offers a valuable technique to guard the ampulla of Vater from injury and blind loop can be avoided by this technique. The outcomes exhibited that patients of DSD attain complete per-oral nutrition in a very brief duration after surgery and subsequently the extent of hospital stay is reduced significantly.

Objective: To compare the outcomes of sclerotherapy with bleomycin versus surgical resection in children with cystic hygroma. Study Design: Comparative/Observational Place and Duration: Paediatric department of Khalifa Gul Nawaz Medical Teaching Institute, Bannu for 20 months duration from 1st August 2019 to 31st March 2021. Methods: Total 40 patients of both genders with ages 1 month to 15 years presented with cystic hygroma were included in this study. Patients' detailed demographics were recorded after written consent from parents/guardians. Patients were divided in to two groups’ i.e. Group A consist of 20 patients and received sclerotherapy with intra-lesional bleomycin and Group B consist of 20 patients received surgical excision. Outcomes were analyzed at post-procedure 3 and 6 months post-procedure and compared the findings between both groups. Results: There was no significant difference observed between both groups regarding age, gender and site of lymphangioma p-value >0.05. In Group A 15 (75%) patients showed excellent results, 3 (15%) patients showed good results and 2 (10%) showed poor results. In Group B 13 (65%) showed excellent results, 4 (20%) showed good results and 3 (15%) showed poor results. At final follow-up there were no patient with recurrence in Group A while in Group B 2 (10%) patients had recurrence, Conclusion: It is concluded that sclerosing treatment with bleomycin is a safe and effective treatment modality with no recurrence as compared to surgical rexection. Keywords: Cystic Hygroma, Sclerotherapy, Bleomycin, Surgery, Recurrence

The use of financial derivatives have been controversial in Islamic Finance. However, the commonly held openion is such derivatives are not Sharīʿah compliant, so should not be used in Islamic Finance. The use of Islamic derivatives in some jurisdiction and not in others on the one hand and the lesser clarity regarding their Sharīʿah basis on the other hand have created uncertainity and thus hindrance for the Islamic financial institutions in properly managing the associated risks. This study is an effort to address the issue and analyze the forwards, futures, options and swaps contracts, from Sharīʿah perspective and to hunt Sharīʿah compliant alternatives to fill this viable gap so that Islamic financial institutions do not find themselves in an unfavorable position. The study adopts qualitative research method to clarify and understand the relevant issues. The analysis shows that, in principle, the current application of derivative instruments in Islamic finance is not Sharīʿah compliant due to a number of forbidden elements. Islamic contracts that can be used as the basis or building block for developing derivatives confirming to the Sharīʿah principles include BaiʿSalam, Murābahah, Wakalah and Wa’ad based arrangements. Based on these Sharīʿah concepts, alternative to Short Selling, FX Forward Contract, Profit Rate Swap and Cross Currency Swap have been examined which will minimize the gape and will help IFIs in development and careful implementation of these structured products as per fundamentals of Islamic Finance, otherwise, it will result a serious breakdown and all the hope of the emerging industry will be lost.