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The article underlines that the epistemology of the self and the practice of life-writing in India marks a departure from the Western conventions and modes of expression. Although there are resistances to autobiography from the Western theoretical standpoint, the genre meets with a twofold resistance in postcolonial milieu in its negotiation with the Indian metaphysics of self. Autobiography in decolonising India negotiates complex pathways between an ardent adherence to Indian epistemology and a potent resistance to the Western modes of writing the self. In a framework to understand the phenomenon of resistance implicit in autobiography in general and the internal resistances to autobiography manifest in the genre during decolonisation in particular, the article argues that such resistances within the genre have redefined the very idea of the self in writing, generated a nuanced notion of the self in narration, as well as challenged the process of writing the self in decolonisation.

Even after adjusting for comorbidities, the outcomes in hemodialysis (HD) patients using a central venous catheter (CVC) as dialysis access are worse than in those with a permanent vascular access. In spite of this, nationwide data suggest that only about 25% of incident HD patients initiate dialysis with an arteriovenous fistula. We conducted a retrospective study to identify reasons and resolution strategies for CVC use in patients who initiated HD at an academic medical center with a well-established chronic kidney disease (CKD) clinic and a dedicated vascular surgeon. Estimated glomerular filtration rate (eGFR) loss over time to record progression of patients to HD was also examined. The charts of 170 consecutive patients were reviewed. Ninety-two percent were found to initiate HD using a CVC. Three factors explained 93% of all CVC in our cohort: absence of adequate predialysis care (45%), acute illness with failure to recover from an episode of acute renal failure (31%), and patient's failure to adhere to scheduled clinic or surgical appointments (17%). In addition, analyses of eGFR suggest that the velocity of GFR loss rather than a defined degree of renal function might be a better trigger for vascular access referral. We conclude that early referral, a close follow up of CKD patients who initiate dialysis due to acute illness, and patient education may have a positive impact to counteract overutilization of CVCs for dialysis. The rate in eGFR decline might also be used to calculate the referral time adequate for fistula creation.

We report a case of Weber-Christian disease confirmed by skin biopsy in a patient who presented with collapsing glomerulopathy and lipophagic interstitial nephritis. On renal biopsy, glomerular visceral epithelial cells, tubular cells, and interstitial macrophages were loaded with inclusions that were morphologically consistent with oxidized lipoproteins, suggesting that lipids derived from the panniculitis may have an etiopathogenic role.