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  1. Fulltext Which is the best method of sterilization for recycled bone autograft in limb salvage surgery: a radiological, biomechanical and histopathological study in rabbit
    Yasin NF, Ajit Singh V, Saad M, Omar E
    BMC Cancer, 2015;15:289.
    PMID: 25884718 DOI: 10.1186/s12885-015-1234-9
    Limb salvage surgery is a treatment of choice for sarcomas of the extremities. One of the options in skeletal reconstruction after tumour resection is by using a recycled bone autograft. The present accepted methods of recycling bone autografts include autoclaving, pasteurization and irradiation. At the moment there is lack of studies that compare the effectiveness of various sterilization methods used for recycling bone autografts and their effects in terms of bone incorporation. This study was performed to determine the effects of different methods of sterilization on bone autografts in rabbit by radiological, biomechanical and histopathological evaluations.
  2. Cellular and humoral responses in the respiratory tract of goats following intranasal stimulation using formalin-killed Pasteurella haemolytica A2
    Zamri-Saad M, Effendy AW, Israf DA, Azmi ML
    Vet Microbiol, 1999 Mar 12;65(3):233-40.
    PMID: 10189198
    A study to determine the immunoglobulin and cellular responses in the respiratory tract of goats following intranasal exposures to formalin-killed Pasteurella haemolytica A2 was carried out. Forty-two goats were divided into two groups. Goats in Group 1 were subjected to double intranasal exposures to formalin-killed P. haemolytica A2 while goats in Group 2 were the unexposed control. Prior to and at weekly intervals post-exposure, three goats from each group were killed, serum samples were collected while the lungs were flushed with 50 ml normal saline before the right apical lobes were fixed in 10% buffered formalin. Both serum and lung lavage fluid were subjected to enzyme-linked immunosorbent assay (ELISA) to determine the levels of IgA, IgM and IgG while the formalin-fixed tissues were examined histologically. IgA levels in the lung lavage fluid increased rapidly to reach a significantly (p < 0.05) high level as early as Week 2 post-exposure and remained significantly (p < 0.05) high throughout the study period. The IgM levels increased at an intermediate rate to reach a significantly (p < 0.05) high level at Week 3 post-exposure before they decreased to an insignificant (p > 0.05) level the following week and the weeks thereafter. IgG levels increased gradually and only reached a significantly (p < 0.01) high level at Weeks 5 and 6 of the study. The size of the bronchus-associated lymphoid tissue (BALT) and the number of lymphocytes in BALT increased significantly from Week 2 and remained high thereafter. However, differences in the numbers of BALT were insignificant (p > 0.05) initially before becoming significantly (p < 0.05) high at Weeks 5 and 6. The BALT responses were parallel to those of imunoglobulins in the lung lavage fluid.
  3. Efficacy of an outer membrane protein of Pasteurella haemolytica A2, A7 or A9-enriched vaccine against intratracheal challenge exposure in sheep
    Sabri MY, Zamri-Saad M, Mutalib AR, Israf DA, Muniandy N
    Vet Microbiol, 2000 Apr 04;73(1):13-23.
    PMID: 10731614
    The outer membrane proteins (OMP) were extracted from the P. haemolytica A2, A7 and A9 to determine their potential as immunogens and their capability for cross-protection. Sixty lambs of approximately 9 months old were divided into four main groups. Animals in Group 1 were vaccinated with 2ml vaccine containing 100microg/ml of the outer membrane proteins of P. haemolytica A2. Animals in Group 2 were similarly vaccinated with the OMPs of P. haemolytica A7 while Group 3 with OMPs of P. haemolytica A9. Animals in Group 4 were unvaccinated control. During the course of the study, serum was collected to evaluate the antibody levels toward each OMP. There appeared to be good immune responses. However, high antibody levels did not necessarily result in good protection of the animals, particularly against cross-infection with P. haemolytica A9 in animals vaccinated with the OMPs of P. haemolytica A2. It seemed that the antibody responses were more specific toward the homologous challenge but generally did not cross-protect against heterologous serotype challenge. However, the OMPs of P. haemolytica A7 produced good in vivo cross-protection and excellent correlations when good antibody responses against all serotypes led to successful reductions of the extent of lung lesions following homologous and heterologous challenge exposures. Thus, the OMPs of P. haemolytica A7 was effective in protecting animals against homologous and heterologous infection by live P. haemolytica A2, A7 and A9.
  4. Severe complications induced by experimental bacterial superinfection of orf lesions
    Zamri-Saad M, Roshidah I, al-Ajeeli KS, Ismail MS, Kamarzaman A
    Trop Anim Health Prod, 1993 May;25(2):85-8.
    PMID: 8236484
    Twelve goats about 3 months of age were divided into 4 equal groups. Goats in Groups 1 and 2 were infected with orf virus followed by Corynebacterium pyogenes infection of Groups 1 and 3, 3 days after the first appearance of orf lesions. Goats in Group 4 were uninfected controls. Complicated orf lesions which consisted of wet suppurative scabs around the entire lips were observed in goats in Group 1. The lesions persisted for 24 days but were most severe from days 8 to 13. Goats in Group 2 developed lesions typical of orf virus infection that lasted 10 days, while goats in Group 3 developed small nodules of about 1 cm diameter, 48 hours following the introduction of C. pyogenes, which persisted for only 6 days. No lesion was observed in goats in Group 4. Two goats in Group 1 with complicated orf died after 16 and 22 days respectively.
  5. The goat as a model for studies of pneumonic pasteurellosis caused by Pasteurella multocida
    Zamri-Saad M, Effendy WM, Maswati MA, Salim N, Sheikh-Omar AR
    Br. Vet. J., 1996 Jul;152(4):453-8.
    PMID: 8791853
    A model of pneumonic pasteurellosis has been established in goats using Pasteurella multocida harvested from pneumonic lungs of goats (types A and D), rabbits (type A) and sheep (type D). The resultant infections were acute, subacute or chronic. The gross and histological lesions of the subacute and chronic infections were typical of pneumonic pasteurellosis. P. multocida type D produced significantly (P < 0.01) more severe lesions when compared with other isolates. There were strong correlations between the clinical signs and the severity of lesions.
  6. Experimental infection of dexamethasone-treated goats with Pasteurella haemolytica A2
    Zamri-Saad M, Jasni S, Nurida AB, Sheikh-Omar AR
    Br. Vet. J., 1991 Nov-Dec;147(6):565-8.
    PMID: 1777800
    Sixteen goats either subjected to transport stress or without transport stress were treated with dexamethasone for 3 days prior to infection with P. haemolytica serotype A2 intranasally. The transport-stressed and dexamethasone-treated goats in the first group had various degrees of pulmonary lesions and the organism was re-isolated from the nasal cavity, lymph nodes and lungs. None of the goats treated with dexamethasone only were infected with P. haemolytica and had no lesions of pneumonic pasteurellosis. Treatment with dexamethasone alone failed to induce experimental infection by P. haemolytica except in combination with another stress factor.
  7. Possible transmission routes of Vibrio spp. in tropical cage-cultured marine fishes
    Nurliyana M, Amal MNA, Zamri-Saad M, Ina-Salwany MY
    Lett Appl Microbiol, 2019 Jun;68(6):485-496.
    PMID: 30834548 DOI: 10.1111/lam.13146
    This study investigates the possible transmission routes of Vibrio spp. in a tropical cage-cultured marine fishes. Samplings of cultured Asian seabass, red snapper, hybrid grouper, wild fish, trash fish, fish fry, water and sediment samples were conducted from December 2016 to August 2017. All fish were dissected in situ and swabs were taken aseptically from the skin, eye, liver and kidney for bacterial isolation and identification. Bacterial isolation and identification from water, sediment and trash fish were also made. A total of 261 Vibrio spp. isolates recovered from the cultured, wild and fry fish, as well as from the sediment and water of the farm environment were analysed. Sequences of the pyrH gene were used to investigate the degree of relatedness and possible transmission routes existing between the isolated Vibrio spp. The population tree revealed the existence of selected Vibrio spp. that possibly transmitted between the newly introduced fish fry and wild fish into the cultured fish, while water also might possibly serves as natural transmission medium of certain Vibrio spp. in this fish farm. SIGNIFICANCE AND IMPACT OF THE STUDY: The source of transmission of Vibrio spp. into farmed marine fish remains unclear. This study highlights the possible transmission routes of Vibrio into cage-cultured marine fishes via newly introduced fish fry and wild fish. Understanding the routes of transmission of Vibrio spp. might help in controlling the disease in the near future.
  8. Pathological changes in the respiratory tract of goats infected by Pasteurella multocida B:2
    Shafarin MS, Zamri-Saad M, Khairani BS, Saharee AA
    J Comp Pathol, 2009 Feb-Apr;140(2-3):194-7.
    PMID: 19110260 DOI: 10.1016/j.jcpa.2008.10.005
    Clinical and pathological changes are described in groups of five goats pretreated with dexamethasone and then infected with a large dose of Pasteurella multocida B:2 (the cause of haemorrhagic septicaemia) by the intratracheal, subcutaneous or intranasal route (groups A, B and C, respectively). In group A, two goats died (on day 1 and 4 post-inoculation); in group B three died (days 2, 5 and 14); and in group C one died (day 20). The infecting organism was recovered from the four goats that died within < or =5 days. The major pulmonary lesions included acute pneumonia, congestion, oedema and hydrothorax. Subcutaneous oedema of the lower jaw and brisket, typically seen in cattle and buffalo, was absent in goats.
  9. Fulltext The effect of diet control on the leptin levels in diabetic pregnant women
    Muna KA, Mokhtar A, Saad MA, Ahmed AA, Akbar JB
    International Medical Journal Malaysia, 2015;14(1):59-63.
    MyJurnal
    Introduction: Leptin is an adipokine that has strong correlation with the body mass index (BMI). Gestational diabetes mellitus (GDM) is a common medical complication associated with pregnancy. Leptin may lose its correlation with the body mass index (BMI) during diabetes due to hormonal rearrangement. Diet control is the first line management in GDM. Leptin reported to increase in pregnancy and further increases in diabetic patients during GDM screening. There is paucity in the reports concerning Leptin levels in GDM patients on diet control. The present study was aimed to evaluate the changes in maternal leptin in pregnancy complicated by GDM on diet control compared to the normal pregnancy in the 3rd trimesters by comparing the means and to find the correlation of Leptin with the body mass index in both groups.
    Methods: The study included 2 groups: normal pregnancy (n = 40) and pregnancy with GDM under diet control (n = 60) both groups are at 38-40 weeks of gestation. Leptin concentration in serum was measured in both groups and statistically tested using student t test. The BMI were measured and correlated with the Leptin level in test groups.
    Results: the results indicated that Leptin will nearly triple in the third trimester (38±30 ng/ml) of pregnancy compared to the standard normal non-pregnant. Leptin level was significantly lower in diabetic women on diet control (28±16 ng/ ml) when compared with the non-diabetics (38±30 ng/ml). The hormone has no correlation with the age of the patients but have a positive correlation with the body mass index before and during pregnancy in both groups.
    Conclusion: Leptin is increasing in pregnancy as part of the physiological changes. Dieting can decrease Leptin level in diabetics’ pregnant women. Diet can restore the hormonal dysregulation of Leptin. Assessment of Leptin level might be used as an indicator for good diet control during pregnancy.
    Study site: Hospital Tengku Ampuan Afzan (HTAA), Kuantan, Pahang, Malaysia
  10. Fulltext Interaction between Pasteurella multocida B:2 and its derivatives with bovine aortic endothelial cell (BAEC)
    Kamal NM, Zamri-Saad M, Masarudin MJ, Othman S
    BMC Vet Res, 2017 Jun 19;13(1):186.
    PMID: 28629460 DOI: 10.1186/s12917-017-1109-1
    BACKGROUND: Pasteurella multocida B:2 causes bovine haemorrhagic septicaemia (HS), leading to rapid fatalities in cattle and buffaloes. An attenuated derivative of P. multocida B:2 GDH7, was previously constructed through mutation of the gdhA gene and proved to be an effective live attenuated vaccine for HS. Currently, only two potential live attenuated vaccine candidates for HS are being reported; P. multocida B:2 GDH7 and P. multocida B:2 JRMT12. This study primarily aims to investigate the potential of P. multocida B:2 GDH7 strain as a delivery vehicle for DNA vaccine for future multivalent applications.

    RESULTS: An investigation on the adherence, invasion and intracellular survival of bacterial strains within the bovine aortic endothelial cell line (BAEC) were carried out. The potential vaccine strain, P. multocida B:2 GDH7, was significantly better (p ≤ 0.05) at adhering to and invading BAEC compared to its parent strain and to P. multocida B:2 JRMT12 and survived intracellularly 7 h post treatment, with a steady decline over time. A dual reporter plasmid, pSRGM, which enabled tracking of bacterial movement from the extracellular environment into the intracellular compartment of the mammalian cells, was subsequently transformed into P. multocida B:2 GDH7. Intracellular trafficking of the vaccine strain, P. multocida B:2 GDH7 was subsequently visualized by tracking the reporter proteins via confocal laser scanning microscopy (CLSM).

    CONCLUSIONS: The ability of P. multocida B:2 GDH7 to model bactofection represents a possibility for this vaccine strain to be used as a delivery vehicle for DNA vaccine for future multivalent protection in cattle and buffaloes.

  11. Fulltext Pathological changes and bacteriological assessments in the urinary tract of pregnant goats experimentally infected with Brucella melitensis
    Mazlina M, Khairani-Bejo S, Hazilawati H, Tiagarahan T, Shaqinah NN, Zamri-Saad M
    BMC Vet Res, 2018 Jun 25;14(1):203.
    PMID: 29940976 DOI: 10.1186/s12917-018-1533-x
    BACKGROUND: This study was conducted to investigate the pathological changes and distribution of B. melitensis in the urinary tract of pregnant goats following acute experimental infection. Six Jamnapari crossbred does in their third trimester of pregnancy were randomly assigned into two groups; Group 1 was uninfected control and Group 2 was inoculated conjunctival with 0.1 mL of the inoculums containing 109 cfu/mL of live B. melitensis. All does were sacrificed 30 days post-inoculation before the kidney, ureter, urinary bladder, urethra and vaginal swab were collected for isolation of B. melitensis. The same tissue samples were fixed in 10% neutral buffered formalin for hematoxylin and eosin, and immunoperoxidase staining.

    RESULTS: None of the goats showed clinical signs or gross lesions. The most consistent histopathology finding was the infiltration of mononuclear cells, chiefly the macrophages with few lymphocytes and occasionally neutrophils in all organs along the urinary tract of the infected goats of Group 2. Other histopathology findings included mild necrosis of the epithelial cells of the renal tubules, congestion and occasional haemorrhages in the various tissues. Kidneys showed the most severe lesions. Immunoperoxidase staining revealed the presence of B. melitensis within the infiltrating macrophages and the epithelium of renal tubules, ureter, urethra and urinary bladder. Most extensive distribution was observed in the urinary bladder. Brucella melitensis was successfully isolated at low concentration (3.4 × 103 cfu/g) in the various organs of the urinary tract and at high concentration (2.4 × 108 cfu/mL) in the vaginal swabs of all infected goats. Although B. melitensis was successfully isolated from the various organs of the urinary tract, it was not isolated from the urine samples that were collected from the urinary bladder at necropsy.

    CONCLUSION: This study demonstrates the presence of low concentrations of B. melitensis in the organs of urinary tract of pregnant does, resulting in mild histopathology lesions. However, B. melitensis was not isolated from the urine that was collected from the urinary bladder.

  12. Temporal bone squamous cell carcinoma: A change in treatment
    Ngu CYV, Mohd Saad MS, Tang IP
    Med J Malaysia, 2021 09;76(5):725-730.
    PMID: 34508382
    Temporal bone squamous cell carcinoma (TBSCC) is a rare head and neck malignancy with the incidence 0.8 -1.0 cases in 1 million population. We are reporting a case series on the TBSCC cases that were operated on at Sarawak General Hospital, Malaysia. Ten patients were identified and collected with the presentation and type of surgery performed. It has been challenging for us to manage with recorded 2 years surviving in 6 out of 10 patients operated within this period. An adequate management with proper surgical resection of tumour and radiotherapy can extend the life expectancy for TBSCC patients.
  13. Ultrastructural pathology of the upper respiratory tract of rabbits experimentally infected with Pasteurella multocida A:3
    Al-Haddawi MH, Jasni S, Zamri-Saad M, Mutalib AR, Sheikh-Omar AR
    Res Vet Sci, 1999 Oct;67(2):163-70.
    PMID: 10502487
    Twenty-four 8 to 9 week-old Pasteurella multocida -free rabbits were divided into three equal groups, the first group was pretreated with hydrocortisone and inoculated intranasally with pasteurella multocida serotype A:3. The second group was inoculated intranasally with P. multocida without hydrocortisone treatment. The third group was inoculated with phosphate buffered saline only and used as a control group. Pasteurella multocida was isolated from the nasal cavity of all infected rabbits in group 1 and 2 and from the trachea of seven rabbits in group 1 and five rabbits in group 2. This study was conducted to observe the ultrastructural changes of the upper respiratory tract of hydrocortisone treated and non-treated rabbits infected with P. multocida serotype A:3. The ultrastructural changes detected in infected rabbits were ciliary destruction and deciliation of the ciliated epithelial cells, cellular swelling, goblet cell hyperplasia and endothelial cell damage. Pasteurella multocida was observed attached to the degenerated cilia, microvilli and mucus. Pasteurella multocida infection was associated with inflammatory responses, which may have caused tissue damage. It is possible that hydrocortisone modulates the severity of infection as an immune suppressor and an inhibitor of goblet cell secretion.
  14. The role of concurrent haemonchosis in the development of pneumonic pasteurellosis in goats
    Zamri-Saad M, Subramaniam P, Sheikh-Omar AR, Sani RA, Rasedee A
    Vet Res Commun, 1994;18(2):119-22.
    PMID: 7975196
  15. Novel hormonal therapies in the management of advanced prostate cancer: extrapolating Asian findings to Southeast Asia
    Ong TA, Saad M, Lim J, Lee HH
    BMC Urol, 2023 Jan 06;23(1):4.
    PMID: 36609251 DOI: 10.1186/s12894-022-01156-8
    There is a paucity of information on the use of novel hormonal agents in Southeast Asian patients. We reviewed the clinical roles of novel hormonal therapy (NHT), namely abiraterone acetate (AA), enzalutamide, apalutamide and darolutamide, in the management of advanced prostate cancer, and data on its use in Asian patients, in order to extrapolate these findings to the Southeast Asian patient population. There are some differences in the molecular features between the NHTs, which influenced their respective permeabilities through the blood-brain barrier. The Asian sub-analyses of the landmark studies of each NHT were limited. The primary endpoints of the Asian sub-analyses generally reflect the efficacy outcomes of the respective landmark study. Hypertension, fatigue, musculoskeletal disorders, rash, and hot flushes were among the common toxicities observed in Asian patients. Real-world data on AA in the Asian setting is favourable, but data is limited for enzalutamide, apalutamide and darolutamide. Based on the sub-analyses and real-world data, the efficacy and safety of NHTs in the Asian patients showed a similar trend to the respective landmark studies. The lack of clinical trials in the Southeast Asian region hampers the ability to make a robust conclusion on any specific efficacy or safety differences that may be present; clinicians must assume that the broader Asian sub-analyses and real-world data reflects Southeast Asian patients' outcomes.
  16. Feline sporotrichosis: an increasingly important zoonotic disease in Malaysia
    Zamri-Saad M, Salmiyah TS, Jasni S, Cheng BY, Basri K
    Vet Rec, 1990 Nov 10;127(19):480.
    PMID: 2270639
  17. Fulltext Structural, Electrical and Electrochemical Properties of Glycerolized Biopolymers Based on Chitosan (CS): Methylcellulose (MC) for Energy Storage Application
    Aziz SB, Asnawi ASFM, Kadir MFZ, Alshehri SM, Ahamad T, Yusof YM, et al.
    Polymers (Basel), 2021 Apr 07;13(8).
    PMID: 33916979 DOI: 10.3390/polym13081183
    In this work, a pair of biopolymer materials has been used to prepare high ion-conducting electrolytes for energy storage application (ESA). The chitosan:methylcellulose (CS:MC) blend was selected as a host for the ammonium thiocyanate NH4SCN dopant salt. Three different concentrations of glycerol was successfully incorporated as a plasticizer into the CS-MC-NH4SCN electrolyte system. The structural, electrical, and ion transport properties were investigated. The highest conductivity of 2.29 × 10-4 S cm-1 is recorded for the electrolyte incorporated 42 wt.% of plasticizer. The complexation and interaction of polymer electrolyte components are studied using the FTIR spectra. The deconvolution (DVN) of FTIR peaks as a sensitive method was used to calculate ion transport parameters. The percentage of free ions is found to influence the transport parameters of number density (n), ionic mobility (µ), and diffusion coefficient (D). All electrolytes in this work obey the non-Debye behavior. The highest conductivity electrolyte exhibits the dominancy of ions, where the ionic transference number, tion value of (0.976) is near to infinity with a voltage of breakdown of 2.11 V. The fabricated electrochemical double-layer capacitor (EDLC) achieves the highest specific capacitance, Cs of 98.08 F/g at 10 mV/s by using the cyclic voltammetry (CV) technique.
  18. Fulltext The Study of Plasticized Sodium Ion Conducting Polymer Blend Electrolyte Membranes Based on Chitosan/Dextran Biopolymers: Ion Transport, Structural, Morphological and Potential Stability
    Asnawi ASFM, Aziz SB, Brevik I, Brza MA, Yusof YM, Alshehri SM, et al.
    Polymers (Basel), 2021 Jan 26;13(3).
    PMID: 33530553 DOI: 10.3390/polym13030383
    The polymer electrolyte system of chitosan/dextran-NaTf with various glycerol concentrations is prepared in this study. The electrical impedance spectroscopy (EIS) study shows that the addition of glycerol increases the ionic conductivity of the electrolyte at room temperature. The highest conducting plasticized electrolyte shows the maximum DC ionic conductivity of 6.10 × 10-5 S/cm. Field emission scanning electron microscopy (FESEM) is used to investigate the effect of plasticizer on film morphology. The interaction between the electrolyte components is confirmed from the existence of the O-H, C-H, carboxamide, and amine groups. The XRD study is used to determine the degree of crystallinity. The transport parameters of number density (n), ionic mobility (µ), and diffusion coefficient (D) of ions are determined using the percentage of free ions, due to the asymmetric vibration (υas(SO3)) and symmetric vibration (υs(SO3)) bands. The dielectric property and relaxation time are proved the non-Debye behavior of the electrolyte system. This behavior model is further verified by the existence of the incomplete semicircle arc from the Argand plot. Transference numbers of ion (tion) and electron (te) for the highest conducting plasticized electrolyte are identified to be 0.988 and 0.012, respectively, confirming that the ions are the dominant charge carriers. The tion value are used to further examine the contribution of ions in the values of the diffusion coefficient and mobility of ions. Linear sweep voltammetry (LSV) shows the potential window for the electrolyte is 2.55 V, indicating it to be a promising electrolyte for application in electrochemical energy storage devices.
  19. Fulltext Opportunities and challenges associated with fecal progesterone metabolite analysis
    Peter ID, Haron AW, Jesse FFA, Ajat M, Han MHW, Fitri WN, et al.
    Vet World, 2018 Nov;11(10):1466-1472.
    PMID: 30532503 DOI: 10.14202/vetworld.2018.1466-1472
    Conventionally, plasma or milk progesterone evaluations are used to determine the reproductive status of female animals. Collection of such samples is often associated with difficulties of animal handling and restraint. Measurable quantities of progesterone metabolites are found in feces of animals. Their concentrations are known to be well correlated to plasma progesterone levels and are, therefore, used as non-invasive samples for assessing reproductive function in a wide range of animal species. Although the analysis of fecal progesterone metabolites has been widely accepted in many laboratories, several factors are known to affect the results from this valuable analytical technique. Some of these factors include storage/transportation media for fecal samples, type of solvent that is used for extraction of progesterone metabolites from feces, and the type and sensitivity of an assaying technique employed. Although fecal progesterone metabolites analysis is associated with some difficulties, it can effectively be used to monitor reproductive function in a wide range of animal species. This review aims to highlight the usefulness of fecal progesterone metabolite analysis as a non-invasive technique in monitoring reproductive function in animals. The article mainly focuses on the many opportunities and challenges associated with this analytical technique.
  20. Impact of Ramadan Focused Education Program on medications adjustment for patients with type 2 diabetes in a primary health care institution in Saudi Arabia
    Tourkmani AM, Alharbi TJ, Bin Rsheed AM, AlRasheed AN, AlBattal SM, Abdelhay O, et al.
    Diabetes Metab Syndr, 2018 08 02;13(1):161-165.
    PMID: 30641690 DOI: 10.1016/j.dsx.2018.07.012
    AIMS: To examine the impact of Ramadan Focused Education Program (RFEP) on medications adjustment in type 2 diabetes patients in Ramadan.

    METHODS: This is a controlled, intervention based study. It was run on three phases: before, during, and after Ramadan on 262 type 2 diabetes patients. The intervention group (n = 140) received RFEP on medications doses & timing adjustment before and after Ramadan, while the control group (n = 122) received standard care.

    RESULTS: The dose of insulin glargine was reduced from 42.51 ± 22.16 at the baseline to 40.11 ± 18.51-units during Ramadan (p = 0.002) in the intervention group while it remained the same in the control group before Ramadan and during Ramadan (38.51 ± 18.63 and 38.14 ± 18.46, P = 0.428, respectively). The hypoglycemia score was 14.2 ± (8.5) pre-Ramadan in the intervention and reduced to 6.36 ± 6.17 during Ramadan (p 

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