Juvenile granulosa cell tumor (JGCT) of testis is extremely rare in childhood. It is considered a benign entity because metastasis has never been reported. Testicular-sparing surgery is the recommended treatment. We reported this case in a newborn who presented with unilateral scrotal swelling. Histopathology and immunohistochemistry confirmed JGCT. Follow-up at 6 months after surgery did not show any recurrence. Even though JGCT is very rare in childhood, it is one of the important differentials of newborn scrotal mass.

INTRODUCTION:Inadequate dialysis accounts for the high mortality in patients with end stage renal disease (ESRD). In Nepal, due to various factors including financial and logistic limitations, hemodialysis is mostly performed twice-a-week. This study was undertaken to look at adequacy of dialysis in patients undergoing maintenance hemodialysis in Nepal where the patients profile, in terms of diet, body muscle mass, nutritional status etc are different from western world.METHODS:In this cross sectional observational study, 40 patients on maintenance hemodialysis in the dialysis unit were evaluated and enrolled if patients were regularly undergoing twice-a-week hemodialysis in preceding 6 months with each session of dialysis prescription consisting of 4 hours (240 minutes). Patients were excluded if they were admitted in the hospital for some acute problems or had received acute hemodialysis in preceding 6 months. Only 14 patients fulfilled the inclusion criteria. Hemodialysis adequacy was measured using well established urea kinetic modeling.RESULTS:The mean age of the patients was 49 +/- 24 years. Mean predialysis urea and post dialysis urea were 163.7 +/- 60.05 mg/dL, and 73.7 mg/dL +/- 30.55 respectively. Mean URR was 65.3%. Mean Kt/v as assessed by Jindals equation was 0.99.CONCLUSIONS:Our study showed that twice-a-week of maintenance hemodialysis did not achieve recommended adequacy of hemodialysis in our patients.Key words: Adequacy of dialysis, end stage renal disease, hemodialysis.