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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.

The chapter understands the Gandhi phenomenon through the intellectual, philosophical and scholastic discourses built around Gandhi and his associates/interlocutors. Although Gandhi’s life is self-explanatory with the affirmation “my life is my message”, the continuing engagements with Gandhi’s life and numerous reflections and afterthoughts about him after seven decades of his death raise some crucial questions: Why is the proliferation of writings/biographies on Gandhi? In what ways do the biographies/correspondences alter the perceptions of reading Gandhi today? What roles do these documents play in constructing and deconstructing the myth called Gandhi? The life-writing in Gandhi’s case is copious – the scholars from India and the West have engaged themselves with the life of mahatma and his philosophy, have written about his life in elaborate detail from his practice of diet, sex, hygiene to his death, with equal commendation and condemnation further leaving enormous potential for the discourse of his life to continue in the future. From the biographers’ varied accounts it appears that it is the one and many Gandhis that are at work in the biographies. Similarly, the numerous exchanges, correspondences among his close associates and interlocutors like Mahadev Desai, J C Kumarrapa, Mirabehn, J Nehru, C F Andrews, Verrier Elwin and Lanza Del Vasto offer a new image of Gandhi which can enrich our nuanced understanding of Gandhi – the man and his philosophy. The present work will critically scrutinise Gandhi’s interface with his interlocutors which can initiate a discourse on its own. The perspective to understand Gandhi – his ideologies, agreements and disagreements among his interlocutors may criss-cross at many levels but what remains is the one yet many-dimensional figure of Gandhi, which equally continues to allure and elude us.

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.

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.