Document Type : Original Article
Authors
1
Forensic Department ministry of Justice, Egypt
2
Nephrology Department, Faculty of Medicine, Ain-Shams University, Cairo, Egypt
3
Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine for Girls, AI-Azhar University, Cairo, Egypt
Abstract
Little attention has been paid to the possibility of cognitive deficits in patients with major organs failure such as the liver, kidney, or heart. Hemodialysis patients are at high risk for cognitive dysfunction, psychometric deficits and metabolic alternations than chronic kidney disease alone that can affect the quality of hand writing and impair its proper recognition. Aim of the study it aims to : Structurally analyze changes in handwriting characteristics among some hemodialysis Egyptian patients and to assess their medico-legal implications of the handwriting . Thirty seven stable hemodialysis patients were included in this study. All the patients were asked to write a sample. Typing tool, writing surface, writing mode and time for filling the form were standardized for all the patients. Qualitative data were presented as frequencies and percentages. Results: Handwriting analysis showed, There was a statistically significant difference (P< 0.001) regarding Writing speed (slow speed (81.1%), medium (13.5%), and very slow speed (5.4%), Pen pressure grades (light pressure (62.2%),heavy pressure (24.3%) and medium pressure (13.5%», word size (large word size (46%), medium word size (40.5%) and small word size (13.5%), Interrupted stroke (97.3%), Curved (zigzag) stroke (100%), Extra stroke (100%) and Stiff stroke(100%), dirtiness(78.4%), spacing represented (97.3%)over-Writing (73%) defined as number of over-writings done by each subject / total number of words written by each subject x 100. Conclusion: hemodialysis patients had a characteristic impairment in handwriting skills which may indicate cognitive deficit that cannot be elicited by clinical examination and investigations. These changes may carry great medico legal implications, and should be considered when analyzing their hand writings.
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