Category: health

Jovina cooks from the Med: Versatile vegetable dips

kaitiscotland2 Comments

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Marinated Olives

Ingredients

1½ cups mixed black and green olives, a combination of Sicilian green olives, Greek Kalamata olives and Spanish green olives
4 tablespoons extra virgin olive oil
1 tablespoon fresh squeezed lemon juice
1 sprig fresh rosemary,
1 teaspoon lemon zest
1/4 teaspoon fennel seeds
1 pinch crushed red pepper
1 clove garlic, sliced thin

Directions

Remove the needles from the rosemary sprig. Discard the stem and chop the needles.

Mix all ingredients together in a bowl until thoroughly combined. Cover and refrigerate for at least 12 hours, stirring occasionally.

Remove the olives from the refrigerator 1 hour before serving to allow them to come to room temperature. Store any leftover olives in the refrigerator, covered, for up to a week.

Red Pepper Hummus

Ingredients

2 cloves garlic, roughly chopped
¼ cup lemon juice
¼ cup water
15 oz canned chickpeas (garbanzo beans)—rinsed and drained
½ cup tahini
1 teaspoon sea salt
½ cup jarred or homemade roasted red peppers, chopped
¼ teaspoon red pepper flakes (chili)
Extra virgin olive oil

Directions

Place all ingredients in a food processor or blender and process until smooth, scraping the sides occasionally. Pour into a serving bowl and drizzle a little extra virgin olive oil.

Tzatziki

Ingredients

1 cucumber, peeled and cut in half lengthwise
2 cups Greek yogurt
2 cloves garlic, minced
1 tablespoon lemon juice
1½ tablespoons finely chopped fresh dill or mint
1 tablespoon extra virgin olive oil
1 teaspoon salt
¼ teaspoon freshly ground black pepper

Directions

Scrape the seeds out of the cucumber halves using the pointy end of a teaspoon and discard.

Grate the cucumber flesh into a bowl then squeeze out any excess moisture using your hands,(a small handful at a time.

Place the grated cucumber into a large bowl and add the yogurt, garlic, lemon juice, olive oil, dill, salt and pepper. Stir well to combine.

Place the tzatziki in the refrigerator for at least 2 hours (and preferably overnight) to let the flavors blend.

All-Purpose Dressing

Ingredients

2½ tablespoons extra virgin olive oil
1½ tablespoons red wine or balsamic vinegar
½ clove garlic, grated
¼ teaspoon each of sea salt and freshly ground black pepper

Directions

Shake together all the ingredients in a jar until well combined.

Tapenade

Tapenade can be used to season grilled fish or chicken. It is also delicious spread on toasted baguette slices and topped with chopped tomatoes or simply serve it with crackers or crusty bread and vegetable crudités for dipping.

Ingredients

1 clove garlic, roughly chopped
1 tablespoon lemon juice
2 tablespoons extra virgin olive oil
¾ cup pitted black olives
1 tablespoon capers
2 anchovy fillets
¼ teaspoon freshly ground black pepper

Directions

Place all ingredients in a food processor or blender and process until smooth. Serve at room temperature.

Peppers and Onions

Ingredients

6 bell peppers, a variety of colors
2 thinly sliced garlic cloves
1 thinly sliced medium onion
1 teaspoons sea salt
1/2 teaspoon coarsely ground fresh black pepper
2 tablespoons red wine vinegar
1/4 cup extra virgin olive oil, plus 1 tablespoon for cooking
1 tablespoon coarsely chopped flat-leaf parsley

Directions

To blister the peppers, place them on a hot grill or under the broiler. Turn on all sides until the skins are completely blackened.

Immediately transfer to a large resealable plastic bag or place in a large bowl and cover the top with plastic wrap to seal. Let sit for 30 minutes, or until cool enough to handle.

Working with one pepper at a time, transfer to a work surface. Remove the skin, stem, and seeds.

Cut the peppers into 2-inch strips.

Heat 1 tablespoon of olive oil in a large frying pan (over medium-high heat).

Add the sliced onions and sauté until the onions soften. Reduce heat to low heat and add the garlic and the sliced peppers. Add the salt and black pepper

Cover the pan and let the mixture stew together for about 5 minutes. Pour the mixture into a storage bowl.

Let sit at room temperature for at least 1 hour, or up to 4 hours to allow the flavors to develop.

Toss with the olive oil, vinegar and parsley just before serving.

Sautéed Greens

Ingredients

3 lbs fresh greens, stems removed and washed in several changes of water
3 garlic cloves, finely chopped
¼ cup extra virgin olive oil
¼ teaspoon red pepper flakes (chili)
Sea salt to taste
1 tablespoon fresh lemon juice.

Directions

Place the greens with the washing water still clinging to the leaves in a large pot.Cook on low until completely wilted and tender, depending on the type of greens used.

Drain and cut the leaves into smaller pieces.

Place the olive oil, garlic and chili in the empty pot and heat over low until the garlic is tender but not brown.

Add the drained greens and cook just until hot. Remove the pan from the heat and stir in salt to taste and the lemon juice.

Thinking clearly: What is mindfulness all about?

kaitiscotland2 Comments

Do you ever just wish you could get someone who knows virtually everything that’s known about the brain and quiz them about mindfulness? Well, I do – a lot – and I just got my wish!

It is my pleasure to present this interview with John McBurney MD. A practicing physician with of over 35 years’ experience, he is board certified in Neurology, Clinical Neurophysiology and Sleep Medicine. Dr. McBurney maintains a daily mindfulness meditation practice as well as home yoga practice.

Could you describe the neurological response to mindfulness practice?

Mindfulness practice ultimately comes down to the concept of neuroplasticity.

In mindfulness, in cultivating awareness of the breath and voluntary moment by moment awareness of the brain, we are training the brain – just like when you are learning to play the violin or any other complex skill – we are training to break out of those self-referential ruminative recursive mental states and to achieve an orientation toward the outer world and in the present moment rather than anticipating the future or reliving the past.

contemplative neuroscience mechanisms behind mindfulness

 Could we be losing something by focusing more on the external realities rather than the self?

Occasionally, we do hear of adverse experiences arising from mindfulness. With any robust intervention there are always potential risks.

How long does it take for mindfulness to have a noticeable effect?

The results can happen almost immediately, however, they are also cumulative. We are still figuring out what the minimum effective dose is. 

What is the relevance of the changes in functional connectivity in the brain in someone who has devoted  a monumental amount of time to meditation, such as Tibetan monks, who may put in more than 10,000 hours in to their practice, compared to the likes of you and me?

A very neat study was published by David Cresswell in Biological Psychiatry in 2016. They invited individuals with high level of stress, unemployed adults, to a weekend retreat experience. They were randomised to in 2 groups:

  • a 3 day mindfulness retreat (the treatment group) and
  • a 3 day relaxation retreat where they read stories, told jokes and had a good time (the control group).

The study was conducted in one centre over one weekend, so it is well controlled. Initially, both groups rated the interventions as being equally helpful to them, subjectively.

The researchers looked at the functional connectivity between the dorsolateral prefrontal cortex and the cingulate gyrus. They also looked at Interleukin-6, a known marker of inflammation, that has been previously shown to be elevated in stressed out unemployed people.

Even with this brief weekend mindfulness intervention, the treatment group developed increased connectivity between the dorsolateral prefrontal cortex and the cyngulate gyrus. There was a neuroplastic response even after a 3 day mindfulness retreat. This was also associated with a decrease in the marker IL-6. Even after 4 months, IL-6 was decreased in the treatment group, but in the control group, IL-6 levels continued to rise, independent of whether they managed to get a job or not.

This is also relevant to doctors, who are at high risk for burnout. Because of their work commitments, the mindfulness retreat for doctors was condensed from the standard 8 week model developed by John Kabat-Zinn to a weekend intervention. The question was: does the weekend model work? The research at the University of Wisconsin where this was developed was reassuring: the residents are less stressed out, more effective and have a greater level of satisfaction.

We still don’t know the absolute minimum dose, but it seems that a weekend of mindfulness can be life-changing for the brain.

Another paper published in PLOS ONE from the Benson-Henry Institute for Mind Body Medicine in Harvard looked at the practices such as meditation, prayer, mindful yoga, Tai-Chi, Qi Gong, etc, i.e. ones that elicit a relaxation response (as opposed the stress response).

This study showed that in both novice and experienced practitioners of relaxation response modalities, there were changes in the epigenetic transcription of the genome. There was upregulation of pathways associated with mitochondrial integrity, downregulation of inflammatory pathways, improved insulin-related metabolism and improved nitric oxide signalling.

Long term potentiation, the standard mechanism for memory formation, strengthens existing neural connections. This happens immediately, as you read this. Over time, long term potentiation leads to formation of new connections,through synaptogenesis, dendritic arborisation and neurogenesis i.e. brain structure changes. In turn, this affects the most neuroplastic neurons located in the hippocampus.

mindfulness minimum effective dose response neurology

In reference to this fascinating recent study of the fight or flight response, it seems plausible that breathing regulates our stress levels much more than conscious thought. Could you explain the significance of this in terms of mindfulness?

The ancients believed that emotions reside in the body. This comes up a lot in serious yoga classes.

This highly innovative study shows that the control of the adrenal medulla – the main effector of the stress response – is not from the conscious ruminating thinking centres, but by the motor and sensory cortex.

This explains why breathing, as well as yoga and Tai-Chi, are an important part of meditative practice. In my experience, these kind of interventions do affect the stress response in a beneficial way.

Mindful exercise exists in many form. For example, weightlifters need to be very mindful to maintain perfect form. Cycling is another example: it is vital to concentrate on every pedal stroke and maintain an even cadence. Once you start to day dream, you notice straight away that your output is way worse. This overlaps with the concept of flow. It is about getting in the zone. There is a very inspiring TED talk by Judson Brewer MD, Ph.D. that explains the physiology behind flow and how it is augmented by mindfulness. Mindfulness is work, and it does require discipline. There is a paradox here of non-striving and non-doing while also being disciplined.

You are a sleep medicine expert. Could you comment on the relationship between mindfulness and sleep?

Insomnia is a complex problem with many causes. However, for most people with idiopathic insomnia, the cause is these self-referential recursive ruminations. They aren’t able to “turn their brain off”. Through mindfulness practice, they are generally able to tame the default mode network that’s responsible for ruminating and daydreaming. A simple strategy would be to lie in bed and concentrate on the breath. This would ease the transition between wakefulness and sleep.

mindfulness default mode network neurological basis for the self

Mindfulness is a mainstay treatment for many mental health disorders. What about use of mindfulness in the treatment for organic pathology of the brain usually treated by neurologists?

There is some preliminary data that mindfulness training has a beneficial effect of seizure frequency in patients with epilepsy. It is a medical condition associated with tremendous anxiety and stress, so mindfulness could have a significant benefit in more than one way. It may even have a benefit it terms of remembering to take medication on time, etc.

Some robust studies show that the frequency of relapse in multiple sclerosis decreases with mindfulness intervention. The effect from mindfulness is similar in magnitude to the effect from beta-interferon. 

John Kabat-Zinn used to take the patients who suffered from chronic pain or had diseases for which we had no answer, and those patients got better. Even beyond neurology, there is some evidence that mindfulness can have benefits in psoriasis. We are probably only at the bottom of this mountain.

Dr McBurney has given me so much to think about. I will follow up with part 2 of our discussion that focuses more on the philosophical and life experience aspects of mindfulness once I wrap my head around it.

neurological path mindfulness default mode network adrenal medulla

Chicken ‘Cordon Bleu’ Rolls

EmmaLeave a comment

Deliciously simple idea for a low-carb chicken dish.

nourishedpeach's avatar


Ok, so this is basically a result of crap, what am I going to make for dinner? I had chicken tenderloins in the fridge and no plan in sight and, truth is, we all need a ‘recipe’ that really doesn’t call for a recipe at all. Something we can just throw together thoughtlessly with no fuss that we can remember off of the top of our heads. So here she be.

My kids love anything that involves ham and Swiss cheese and we had both in the fridge so I threw it all together and let’s just say I’ll certainly be making this one again.

No pounding out the chicken, no cutting slits to stuff it, nada. Just a chicken tenderloin wrapped arpund ham and Swiss in the middle. And baked until the cheese gets gooey and the chicken is cooked to juicy perfection. So stinking basic, but that salty…

View original post 177 more words

The link between hypoglycaemia, cardiac arrythmia, and dead in bed syndrome

kaitiscotland1 Comment

ecg

 

Arrhythmia incidents differ in nocturnal and diurnal hypoglycemic patients.

In young adults with type 1 diabetes (T1D), severe hypoglycemia may increase the risk of all-cause mortality and cardiovascular diseases.

According to Peter Novodvorsky, from the University of Sheffield in the United Kingdom, and his colleagues, there are differences in arrhythmic risk and cardiac repolarization during nocturnal versus daytime hypoglycemia. Hypoglycemia may exert proarrhythmogenic effects on the heart by sympathoadrenal stimulation and hypokalemia. The dysrhythmias induced by hypoglycemia have been associated with the “dead-in-bed syndrome,” a devastating condition that is rarely heard of. In this study, the effects of nocturnal and daytime clinical hypoglycemia are examined through electrocardiogram (ECG) in young people with T1D.

In an observational study, 37 participants were recruited from Sheffield Teaching Hospitals outpatient clinics with a median age of 34 years with T1D for at least four years. The purpose of this study was to examine the effect of clinical hypoglycemia in T1D patients age 50 or less and compare it with matched euglycemia on the frequency of cardiac arrhythmias, HRV, and cardiac repolarization.

Participants were told to avoid vigorous exercise, caffeine, and smoking 12 h prior to monitoring. Hypoglycemia awareness was assessed using a visual analog scale of 1 to 7. All subjects underwent 96 h of simultaneous  ECG and blinded continuous interstitial glucose monitoring (CGM) while continuing daily activities and symptomatic hypoglycemia were recorded.

The researchers obtained 2,395 hours of simultaneous ECG and CGM recordings with 159 and 1,355 hours designated hypoglycemia and euglycemia respectively. The median duration of hypoglycemia was longer during the night (60 min) than daytime (44 min) [P =0.020]. Overall, there were 24.1% of nocturnal and 51% of daytime symptomatic episodes respectively.

Bradycardia (low heart rate ) was more frequent during nocturnal hypoglycemia in comparison to matched euglycemia with an incidence rate ratio [IRR] 6.44 [95% CI, 6.26-6.66; P <0.001].

During daytime hypoglycemia, bradycardia was less frequent with an IRR 0.023 [95% CI, 0.002-0.26; P =0.002], while atrial ectopic was more frequent (IRR: 2.29; 95% CI, 1.19-4.39; P =.013). Moreover, during nocturnal and daytime hypoglycemia there was decreased T-wave symmetry, but prolonged QTc and T-peak to T-end interval duration.

The study confirmed that asymptomatic hypoglycemia commonly occurs in T1D. This causes abnormal heart rhythms and these are more abnormal at night, more frequent  and last longer.

 

Practice Pearls:

  • Hypoglycemia is pro-arrhythmogenic.
  • The study confirmed that there is high frequency of hypoglycemia, particularly of nocturnal asymptomatic episodes among young people with type 1 diabetes.
  • Hypoglycemia-induced mechanism is independent of the type of diabetes, age, or cardiovascular risk profile.

References:

  1. American Diabetes Association. 5. Glycemic targets. Diabetes Care. 2016;39 (Suppl. 1):S39–S46
  2. Nordin C. The case for hypoglycaemia as a proarrhythmic event: basic and clinical evidence. Diabetologia. 2010;53:1552–1561
  3. Novodvorsky P, bernjak A, Chow E, Iqbal A, Sellors L, Williams S, et al. Diurnal differences in risk of cardiac arrhythmias during spontaneous hypoglycemia in young people with type 1 diabetes. Diabetes Care. 2017, Feb 17.

From Diabetes in Control  18th March 2017

 

Fit to serve: Cinnamon coffee cake

kaitiscotland4 Comments

coffee cake

Low Carb Sour Cream Cinnamon Coffee Cake

by fittoservegroup

 

Low Carb Sour Cream Cinnamon Coffee Cake

Ingredients

2 cups of almond flour finely milled

1 ¼ cup of sugar substitute

2 tablespoons of baking powder

2 1/2 teaspoons of ground cinnamon

1 teaspoon of sea salt

¼ teaspoon of baking soda

¼ teaspoon nutmeg

½ cup (1 stick) melted butter cooled

1 cup of sour cream

2 eggs

Low Carb Crumb Topping

Ingredients

1 cup of almond flour (I used finely milled)

½ cup of coconut flour

½ cup of sugar substitute (I used Swerve)

½ cup of your favorite low carb nuts (I used pecans)

½ cup (1 stick) cold butter sliced thinly

2 teaspoons of ground cinnamon

¼ teaspoon of sea salt

Instructions

  1. Pre-heat oven to 350 degrees. Butter a 9-inch spring-form cake pan.
  2. Make the crumb topping: In a small bowl, combine the sugar substitute, almond flour, coconut flour, pecan nuts, salt and cinnamon. To the dry ingredients add I thinly sliced cold butter and cut in the butter until the mixture resembles coarse crumbs. Set aside.
  3. Cake batter: In a large mixing bowl, combine the almond flour, sugar substitute, spices, baking powder, baking soda, sea salt. In a small bowl, stir the cooled melted butter, sour cream, and eggs until they are well combined. Fold the butter & sour cream mixture into the batter dry ingredients. Mix until well incorporated. Spread the batter into the spring-form pan and sprinkle the crumb topping over the cake.
  4. Bake the cake for 45 minutes to 1 hour, or until the crumbs are lightly browned and until an inserted toothpick comes out clean.
  5. Cool the cake for 20 minutes before slicing and serving.

Serves 15  3.6 net carbs per slice

Enjoy in good health!

 

Lost to follow up diabetic patients do badly

kaitiscotland2 Comments

 

DNA_Daily_News_and_Analysis_New_Logo.svg

 

People with diabetes who had annual diabetes checks in the previous seven years had half the mortality rate of those who did not attend. 

This study  in England and Wales for the National Diabetes Audit 2015-16 also revealed that type ones have a mortality rate 127.8% more than the general population and those with type two diabetes are 28.45 more likely to succumb earlier than they otherwise would.

My comment: These seem very disturbing figures especially for type ones. Of course type ones are still not being guided about having normal blood sugars. There could be a reverse causality here going on as well, with the least fit people, perhaps housebound or with amputations or with visual problems less able to attend clinics. In my area there is a good deal of effort put into tracking down children who don’t attend clinics, but once they move to the adolescent and adult clincs there does not seem to be the provision of liaison nurses to do outreach work. 

 

Adapted from news article BMJ 22 July 17

 

Avocado Stuffed Salmon

Emma1 Comment

A delicious idea for salmon and avocado!

nourishedpeach's avatar


Hey you! How can it be that we’ve been this out of touch?! Are you getting into the swing of your fall routine? This summer seemed to fly by in the blink of an eye. I hope you have been enjoying this crazy, hectic time!

All is so very well over here. We are feeling like we’ve got this “new start” thing down. Georgia is literally jumping with joy about kindergarten so far. She’s been an absolute champ with all of the newness and I couldn’t feel more proud of her. Jude’s doing his part time preschool thing and is loving his own special time with a wonderful teacher and friends…he’s such a little sponge and has an amazing, curious nature. And Rocco, well, chubby, happy and the most sweet spirited little human I’ve ever known. He brings so much joy to all of us.

Having been away from blogging…

View original post 632 more words

Gretchen Reynolds: You are never too old to give up on exercise

kaitiscotland3 Comments

cyclist robert marchand

At the age of 105, the French amateur cyclist and world-record holder Robert Marchand is more aerobically fit than most 50-year-olds — and appears to be getting even fitter as he ages, according to a revelatory new study of his physiology.

The study, which appeared in December in The Journal of Applied Physiology, may help to rewrite scientific expectations of how our bodies age and what is possible for any of us athletically, no matter how old we are.

Many people first heard of Mr. Marchand last month, when he set a world record in one-hour cycling, an event in which someone rides as many miles as possible on an indoor track in 60 minutes.

Mr. Marchand pedaled more than 14 miles, setting a global benchmark for cyclists age 105 and older. That classification had to be created specifically to accommodate him. No one his age previously had attempted the record.

She was particularly interested in Mr. Marchand’s workout program and whether altering it might augment his endurance and increase his speed.

Conventional wisdom in exercise science suggests that it is very difficult to significantly add to aerobic fitness after middle age. In general, VO2 max, a measure of how well our bodies can use oxygen and the most widely accepted scientific indicator of fitness, begins to decline after about age 50, even if we frequently exercise.

But Dr. Billat had found that if older athletes exercised intensely, they could increase their VO2 max. She had never tested this method on a centenarian, however.

But Mr. Marchand was amenable. A diminutive 5 feet in height and weighing about 115 pounds, he said he had not exercised regularly during most of his working life as a truck driver, gardener, firefighter and lumberjack. But since his retirement, he had begun cycling most days of the week, either on an indoor trainer or the roads near his home in suburban Paris.

Almost all of this mileage was completed at a relatively leisurely pace.

Dr. Billat upended that routine. But first, she and her colleagues brought Mr. Marchand into the university’s human performance lab.

They tested his VO2 max, heart rate and other aspects of cardiorespiratory fitness. All were healthy and well above average for someone of his age. He also required no medications.

He then went out and set the one-hour world record for people 100 years and older, covering about 14 miles.

Afterward, Dr. Billat had him begin a new training regimen. Under this program, about 80 percent of his weekly workouts were performed at an easy intensity, the equivalent of a 12 or less on a scale of 1 to 20, with 20 being almost unbearably strenuous according to Mr. Marchand’s judgment. He did not use a heart rate monitor.

The other 20 percent of his workouts were performed at a difficult intensity of 15 or above on the same scale. For these, he was instructed to increase his pedaling frequency to between 70 and 90 revolutions per minute, compared to about 60 r.p.m. during the easy rides. (A cycling computer supplied this information.) The rides rarely lasted more than an hour.

Mr. Marchand followed this program for two years. Then he attempted to best his own one-hour track world record.

First, however, Dr. Billat and her colleagues remeasured all of the physiological markers they had tested two years before.

Mr. Marchand’s VO2 max was now about 13 percent higher than it had been before, she found, and comparable to the aerobic capacity of a healthy, average 50-year-old. He also had added to his pedaling power, increasing that measure by nearly 40 percent.

Unsurprisingly, his cycling performance subsequently also improved considerably. During his ensuing world record attempt, he pedaled for almost 17 miles, about three miles farther than he had covered during his first, record-setting ride.

He was 103 years old.

These data strongly suggest that “we can improve VO2 max and performance at every age,” Dr. Billat says.

There are caveats, though. Mr. Marchand may be sui generis, with some lucky constellation of genes that have allowed him to live past 100 without debilities and to respond to training as robustly he does.

Lifestyle may also matter. Mr. Marchand is “very optimistic and sociable,” Dr. Billat says, “with many friends,” and numerous studies suggest that strong social ties are linked to a longer life. His diet is also simple, focusing on yogurt, soup, cheese, chicken and a glass of red wine at dinner.

But for those of us who hope to age well, his example is inspiring and, Dr. Billat says, still incomplete. Disappointed with last month’s record-setting ride, he believes that he can improve his mileage, she says, and may try again, perhaps when he is 106.

A version of this article appears in print on February 14, 2017, on Page D4 of the New York edition with the headline: Lessons From a 105-Year-Old. Order Reprints| Today’s Paper|Subscribe

Fit to serve: Lasagne using spaghetti squash

kaitiscotlandLeave a comment

ricotta

 

Buried Alive!

kaitiscotland1 Comment

burried alive

Adapted from : Hysterical Paralysis and premature burial: A medieval Persian case, fear and fascination in the west, and modern practice. 

By Paul S Agutter et al Journal of Forensic and Legal Medicine April 2013

The fear of premature burial is ancient but reached its heights in 18th and 19th century Europe. The fear has a modern equivalent, the fear of organs being harvested from a living patient. The certainty of a diagnosis of death are of medical and public concern. The diagnosis of brain death remains controversial.  Although multimodality evoked potentials are considered the most accurate way of determining irreversible brain death, doubts remain as to whether any test of brain death can be infallible.

Public fascination remains widespread. Past cases occasionally surface, it is a fear that pervades literature and film, and various means of prevention have been mooted. Some cases involve hysterical paralysis and this article discusses a case of this which arose in Qajarid Persia.

A family  of tobacco farmers had a 14 year old girl. The mother went to waken her daughter to get her ready for a day of work on the farm. As she didn’t want to do this the girl refused but her mother forced her out of bed. Immediately, the girl fell back on the bed and remained motionless. Thinking that her daughter had stopped breathing, the mother started to shout and cry. Other household members came into the bedroom and were also convinced that the girl had no breath or pulse. Partly due to poverty and partly due to the difficulty in obtaining a doctor, the family considered the girl to be dead and arranged the burial.

The girl’s body was washed and anointed as was the custom. A wise old woman observed that there appeared to be some movement of the girls head and hand and urged the family to wait overnight to see if recovery would occur. She was overruled and the girl was buried.

The old woman did manage to convince the girl’s brother, so shortly after burial, he exhumed the body. He found her motionless and reburied her.

The next morning a neighbour came to the house saying that he had been disturbed by a dream that indicated that the girl was alive. After a lot of dispute, the grave was eventually opened up again in the afternoon.

This time, the girl was indeed dead, but she had changed her position, was now lying curled up on her front,  and had banged her head on the stone covering the grave when she had tried to untie her shoe ties.  A lot of blood had come from the head wound. A tragedy for the entire family.

cobra

Muslim burials are usually carried out within 24 hours of death and sometimes very soon after death.  This was no doubt a factor in this case.

Hysterical paralysis is not the only condition that can simulate death. Severe trauma, Guillain-Barre syndrome, acute polyneuropathies and the effects of a cobra bite can mimic death.

Cardiac arrythmias, typhoid fever, brain stem stroke, and infectious disease epidemics have led to premature burials in the past.

Even in the present day, natural disasters, occupational accidents and the effects of war can lead to entrapment.

Hysterical conversion disorders can cause apparent paralysis and somatosensory loss that are difficult to explain medically. Sufferers tend to have psychosocial and emotional difficulties. But genuine disorders such as poliomyelitis, relapsing tetanus, neurological diseases,  spinal injury, acute transverse myelitis and stiff-person syndrome can mimic hysterical conversion disorders.

Fortunately if you test a person who has a conversion disorder with multi-modality evoked potentials, they show up very much alive but with certain areas of the brain working differently from the usual pattern.