Two Arm Single-blind Parallel Randomized Controlled Trial Effects of Health Education Intervention on Foot Self-care Behavior Among Diabetic Patients: Study Protocol

@#Introduction: Diabetes is a chronic illness and it has a significant impact on health. Behavioral interventions theory could improve self-care practices of the foot among patients with diabetic. Behavioral interventions could prevent the risk of foot problems. This trial aims at determining the effect of patient education intervention on foot self-care behavior and clinical outcomes among diabetes patients. Methods: The study is a two-arm single-blinded randomized controlled trial which will be conducted in the Federal Medical Centre (FMC) Owerri, Imo state, Nigeria involving 160 diabetic patients. A central computer-generated randomization list will be generated. Sequentially numbered sealed opaque envelopes will be used to determine concealment. The sample size is 160; therefore 80 participants will receive three sessions of patient education in addition to usual care (intervention group) for three and six months while another 80 participants (control group) will receive only usual care and will receive health education after the study is completed. The outcome of the intervention effectiveness is measured by modified version of Diabetes foot Self-Care Behavior Scale (DFSBS). Discussion: Our hypothesis is that based on the Health Belief Model, patient education intervention can improve foot self-care behavior in the intervention group. Data collection will be done at baseline, and at three- and six-months post intervention. Trial Registration: The Clinical Trials Registry- India (CTRI), Reference no CTRI/2021/06/034311.

Barriers and Facilitators Factors to Uptake of Cervical Cancer Screening Among Women in Low- and Middle-income Countries: A Narrative Review

@#Cervical cancer is a worldwide health issue. Each year, it kills hundreds of thousands of women worldwide. Despite the availability of screening tests, the incidence of cervical cancer remains high in low and middle-income countries. In this review, we survey the current literature on factors affecting cervical cancer screening uptake among women in low and middle-income countries. It also highlights potential strategies for improving screening uptake and suggests directions for future research. Knowledge about cervical cancer and its screening, socio-demographic factors, personal and behavioural factors, cultural factors and beliefs, and health service factors are considered the main barriers and facilitators to cervical cancer screening uptake among women in low and middle-income countries. Understanding the facilitators and barriers to cervical cancer screening encountered by women in low and middle-income countries can improve screening uptake by overcoming inequalities in resource and information access. Culturally sensitive screening programs, improvement of the health system, and health education interventions to raise awareness of screening and its benefits can be effective strategies to improve screening uptake among women in low and middle-income countries.

Improving Foot Self-care Practices Through Health Education Intervention Programs Among Diabetic Patients: A Systematic Review

@#Introduction: Diabetic foot ulcers (DFUs) remain one of the greatest significant problems of diabetes mellitus. It is a cause of main suffering and expenses for patient, and financial problem on health facilities and public. One of the strategies to overcome DFU is through health education to prevent foot ulcer, which focused in promoting foot self-care. To reach this aim, researchers had applied different educational approaches. This systematic review is to evaluate various types of educational programs in terms of its method of delivery and effectiveness. Methods: The search involved various databases; EBSCOHOST, MEDLINE, CINAHL, Cochrane library, ScienceDirect, PubMed, SAGE SringerLink, Web of Science and Wiley Online Library. It was limited to full text research articles that report intervention studies, and the writte up in English Language, the publication was from 2005 to 2021. The key words were “diabetes”, “diabetes foot”, “foot self-care”, health education and “interventions”. Results: Twenty studies were involved in this review. Nine studies were randomized controlled trials (RCTs), while eleven reported non-randomized controlled trials (NRCTs). Conclusion: There are evidences that foot care education improves foot care and diabetic foot problems. Various health education approaches, for instance foot assessment, discussion, counseling, homebased visitation and telephone calls have been shown to be effective in improving educational programs. Studies in the future should focus on RCTs in different sites and apply follow-up of long duration to provide better recommendations to healthcare practitioners on effective educational interventions to prevent DFUs.

Prediction of Relapse Among Individuals Undergoing Methadone Maintenance Therapy in Johor Bahru Health District

@#Introduction: Increase in the number of opioids seized in the recent year may indicate increased opioid use in Malaysia. In counteracting opioid abuse, Methadone Maintenance Therapy (MMT) was introduced in Malaysia but relapse following MMT has become an important issue. This study aimed to determine the prevalence and patient factors that served as predictors of opioid relapse among MMT patients. Method: A cross-sectional study involving 159 MMT patients who have reached dose stabilization (eight weeks at a constant dose of methadone) was conducted in Johor Bahru Health District. The dependent variable was opioid relapse, while the independent variables include socio-demographic characteristics, MMT history, crime history, cognitive and interpersonal factors, and social-environment influence. Face-to-face interviews using structured questionnaires and secondary data collection using data collection sheets were done. Multiple logistic regression was used to determine the predictors. Significant level set at alpha less than 5%. Result: The response rate was 86.9% with majority of them were Malay, male, and Muslim. The prevalence of opioid relapse was 11.9%. Those who were non-polydrug users (AOR=3.701, 95%CI=1.182, 11.587, p=0.025), classified as having moderate (AOR=5.869, 95%CI=1.524, 22.595, p=0.010) and high (AOR=5.952, 95%CI=1.000, 35.445, p=0.050) relapse risk response after given hypothetical situation whether respondent been offered drug or not, were more likely to have relapsed. Respondents with higher cognitive and behavioral problem-solving response scores were less likely to have relapsed (AOR=0.949, 95%CI=0.909, 0.991, p=0.008). Conclusion: About 1 in 5 MMT clients had relapsed after they reach dose stabilization. The predictors of opioid relapse were non-polydrug users, having moderate to high relapse risk, and cognitive and behavioral problem-solving responses.

A Systematic Evaluation of Methods Used and the Effectiveness of Health Education Interventions to Improve Knowledge, Beliefs, and Practices of Cervical Cancer Screening

@#Introduction: Screening of cervical cancer had decreased its morbidity and mortality in developed countries. Health education interventions are expected to enhance knowledge, attitude and practice of screening. Their success rely on designs and methods. Thus, this systematic review aims to identify the methods used and the effectiveness of health education interventions in improving knowledge, beliefs, and practices of cervical cancer screening among women of reproductive age. Methods: A systematic review of all published eligible studies in (PubMed, Science Direct and MEDLINE) databases from 1st of January 2016 to 31st of October 2020 was run using different keywords. A total of 14 research articles were included. The quality and risk of bias of studies was assessed by using EPHPP and the average score was given accordingly. This study was registered in PROSPERO (record #CRD42020188462). Results: The review combined 14 studies. Five studies were conducted in the USA, two in Hong Kong, one in Korea, one in England, one in Denmark, one in Norway, one in Turkey, one in Malaysia and one in Tanzania. Almost all interventions boosted the knowledge, attitude or screening uptake. Conclusion: This review showed that the most popular methods of delivering health intervention were health talk, Group discussion and pamphlet. Health education interventions was effective in improving the knowledge, attitude and screening uptake. Although, this effect differs according to methods of delivery, study background and populations. Therefore, it is better to understand the existing situation to develop the best intervention and more studies are needed to recognise barriers to screening.

Educational Intervention for Informal Caregiver of Person with Dementia: A Systematic Review

@#The role of caregivers is very important in the management of person with dementia, where it is not uncommon for them to experience psychological distress. However, the level of distress can be managed and reduced through strategic educational intervention. A systematic review has been conducted through searching Medline, Science direct, Cochrane library and EMBASE databases to provide a narrative synthesis that elaborate on methods and outcomes of the educational intervention among informal caregiver of person with dementia. From a total of 5125 records, eight studies were selected and included in this review, where the results show that educational intervention can be implemented either as individual or group intervention. Group intervention methods mainly focus on training programs such as workshops and lectures, and also group-based discussions. While for individual intervention, most of the activities were implemented through self-learning using technology or computer-based systems. In conclusion, based on the outcome of the studies, both methods of implementations are found to be useful in reducing psychological distress of the informal caregiver.

Association of Parental Knowledge, Attitude, and Practice of Oral Health With Early Childhood Caries Among Preschool Children: A Systematic Review

@#Early childhood caries (ECC) is a serious public health problem in both developing and developed countries. Given that children mainly depend on their parents for their day-to-day activities, it is important to investigate the extent of parental influence on the oral health of their children. The objective of this study is to review the association of parental knowledge, attitude, and practice of oral health with ECC among preschool children. PubMed, Medline, and Google scholar were used to search for related articles published within the past 10 years. All of the studies that investigated parental oral health practice have shown association with the development of dental caries. However, there were discrepancies in the outcome of studies that examined the association of parental knowledge and attitude with ECC. More investigations on parental knowledge and attitude are needed to clarify their association with ECC.

Predictors of Good Glycemic Controls Among Type 2 Diabetes Mellitus Patients in Two Primary Health Clinics, Kuala Selangor

Abstract@#Introduction: The objective of this study was to determine the factors and predictors of good glycaemic control among patients with Type 2 Diabetes Mellitus (T2DM) in two rural government health clinics in Kuala Selangor. Methods: This cross-sectional study involved 200 patients selected through systematic random sampling from a list of T2DM patients in two government health clinics in Kuala Selangor. Data was collected using a self-administered questionnaire while glycosylated haemoglobin (HbA1c) results were obtained from the patients’ blood results record at the clinic. HbA1c of 6.5 % and below was categorized as good glycaemic control. The factors studied were socio-demographic characteristics (age, gender, ethnicity, level of education, occupation and household income), T2DM medical history (T2DM duration and type of treatment), diabetes knowledge, health literacy, adherence to treatment, body mass index (BMI) and physical activity. Pearson’s chi square test was used to test for associations and multiple logistic regressions were used to determine the predictors. Results: The response rate was 86.9%. The proportion of good glycaemic control was 34.0%. Level of glycaemic control was significantly associated with duration of being diagnosed with T2DM (p=0.006) and type of treatment (p=0.009). The probability of having good glycaemic control was 2.5 times more likely among respondents diagnosed with T2DM for less than 10 years (AOR=2.458, 95% of CI=1.504-14.282, p=0.037). Conclusion: Shorter duration of being diagnosed with T2DM has been found to be a predictor of good glycaemic control in this study population, thus warranting stricter monitoring among patients who have been diagnosed for a longer period.

Family Planning Practice Among Married Orang Asli Women in Sepang District and Its Associated Factors

Abstract@#Introduction: Family planning allows couples to have their desired number of children and optimum birth spacing. While the contraceptive prevalence rate (CPR) in Malaysia was reported as 52.2% in 2014, little is known regarding the practice of family planning among marginalised groups such as the Orang Asli women. This study aims to determine family planning practice among married Orang Asli women in Sepang district and its associated factors. Methods: A cross sectional study using a pretested questionnaire was conducted in five Orang Asli settlements in Sepang using cluster sampling. Chi-square test and simple logistic regression were used in bivariate analysis, whereas binary logistic regression was used to determine the predictors of family planning practice. Results: 212 (58.4%) participants were current users of family planning, with 68.3% of the users reported using oral contraceptive pills. In the logistic regression models, family planning practice was significantly more common among women who had children (AOR= 43.659, 95% CI: 5.788, 329.323), being housewives (AOR=1.973, 95% CI: 1.205, 3.230) and had higher attitude score (AOR=1.113, 95% CI: 1.006, 1.232). Conclusion: The CPR of current study was about the same as the national CPR in 2014. The predictors of family planning practice among Orang Asli women were having children, being a housewife and having a better attitude towards family planning. Future intervention to increase the CPR should focus on improving women’s attitude regarding family planning.

Effect of Physical Activity Intervention on Physical Activity, Body Mass Index, Blood Pressure, Blood Lipid and Fasting Blood Sugar Among Overweight and Obese Military Personnel

Abstract@#Introduction: About 18% of Malaysian Armed Forces (MAF) personnel are diagnosed with either hypertension, diabetes or coronary artery disease, while another 8% are obese. The rising prevalence necessitates intervention. Methods: This is a single blinded randomized controlled trial among overweight and obese MAF personnel attending medical checkup in MAF hospital in Kuala Lumpur. An intervention module was developed to increase their physical activity level. Short version of International Physical Activity Questionnaire was used to assess physical activity in metabolic equivalent of task score (METs score), while blood pressure, body mass index (BMI), blood lipid profile and fasting blood sugar measurements were also obtained. These parameters were measured at baseline and again at 6 months. Generalized estimating equations (GEE) statistical test were applied to evaluate the effect of the intervention. Results: Response rate was 100%. Most of participants were aged above 40 years, male, from Malay ethnic group, completed secondary education and had monthly income above RM 4000. Most of the respondents were obese and had moderate level of physical activity at baseline. All variables compared between groups at baseline showed no significant difference. At six months, after controlling for covariates, the significant difference was only in METs score. The odds of having high METs score in the intervention group after receiving intervention was nearly 3 times higher than those in the control group, after adjusting for interaction between time and group as well as other covariates (AOR = 2.908, 95% CI 1.323 – 6.391, P=0.008). Conclusion: Intervention was effective in increasing physical activity among overweight and obese military personnel.

Comparison of time-restricted feeding and Islamic fasting: a scoping review

Background: research on the health benefits of fasting is growing; this includes time-restricted feeding and Islamic fasting

Aims: this article aims to review and highlight the similarities and differences between time-restricted feeding and Islamic fasting during Ramadan

Methods: a scoping review was undertaken to identify relevant articles that answered the research question: what are the similarities and differences in characteristics of time-restricted feeding and Islamic fasting? MEDLINE/PubMed was searched using the terms: time-restricted feeding, and weight. Inclusion criteria were: original research and review articles; written in English; and published between the years 2000 and 2017

Results: a total of 25 articles that answered the research question were included in the review: 15 original research papers and 10 reviews. The findings suggest that Ramadan fasting is a form of time-restricted feeding in the contemporary context because of the period when eating is not allowed. The fasting duration reported in time-restricted feeding ranged from 4 to 24 hours, which is longer than that of Islamic fasting which is between 8 and 20 hours. Both time-restricted feeding and Islamic fasting have been found to have positive health effects, including weight reduction

Conclusion: time-restricted feeding and Islamic fasting have many similar characteristics and reported positive health effects

Factors associated with awareness, knowledge and attitude towards prostate cancer among Malay men in traditional Malay villages, Negeri Sembilan, Malaysia

@#Background: Lack of awareness, poor knowledge and attitude regarding cancer have been identified as possible reasons accounting for the late presentation which lead to the poor survival of cancer patients in Malaysia. Method:A cross sectional study was conducted in three traditional Malay villages in Negeri Sembilan among adult males. Those who were already diagnosed with prostate cancer or Non malaysians were excluded from the study. Data was collected using self-administered questionnaires which consist of several sections namely socio-demographic, awareness about prostate cancer, sources of information, family history of prostate cancer, lifestyle associated with risk of cancer, knowledge and attitude towards prostate cancer. Data was analysed using SPSS version 22.0. Chi-square test was used to determine associations. Level of significance was set at p<0.05. The knowledge and attitude scores were then categorized into 2 levels (50% or more of total score equals to ‘good’ and less than 50 % equals to ‘poor’). Results: A total of 168 respondents participated in this study and 62.1% of them had heard about prostate cancer and it is associated with level of education, monthly income and age (p= 0.023, 0.007 and 0.022). Most common sources of information are television, newspaper and friends (52.8%, 43.4% and 39.6% respectively). Among those who had heard about prostate cancer, 58.5% had good knowledge and this was significantly associated with smoking status (p =0.022). Conclusion: The percentage of awareness, knowledge and attitude regarding prostate cancer among the study population are still low. More effort should be carried out especially among men in rural communities to improve the situation.

Influence of an intervention program promoting voluntary fasting practices and its perceived barriers among overweight or obese Muslim women working in the public sector, Malaysia

@#Introduction: This article aims to describe the effect of an intervention to promote the practice of voluntary Islamic fasting and its barriers among a group of overweight and obese Muslim women working in the public sector in Malaysia. Materials and methods: In this quasi-experimental study, an intervention to encourage voluntary fasting was delivered in a half day seminar, supported by relevant booklets prepared. A self-administered questionnaire was used to capture data on voluntary fasting practices and its perceived barriers before and four months after the intervention. Data was analysed using Mc Nemar test to compare the proportion before and after the intervention. Significant level was set at p<0.05. Results: A total of 56 women were recruited. Their mean age was 36.65 years, most were married, had formal education up to secondary level and median income of RM 3000 per month. At baseline, 60.7% of them have practiced voluntary fasting. After intervention, the number of participants who practices voluntary fasting increased with a significant increase in three types of voluntary fasting (i.e. Mondays only, Thursdays only and 6 days in Shawal). The highest barrier to practice voluntary fasting was having no motivation to do so, followed by work commitment, health problems and family commitment. Discussion and Conclusion: Most of the respondents could practice voluntary fasting regularly if motivated to do so and backed by social support both at work and at home.

Identifications of drug resistance mutations among antiretroviral treatment naive HIV-1 patients in Peninsular Malaysia

OBJECTIVE@#To determine drug resistance mutations and the HIV-1 subtypes among antiretroviral treatment naive HIV-1 patients in Peninsular Malaysia.@*METHODS@#A total of 45 samples from four hospitals that provide HIV viral load services were subjected to the amplification of the protease and two third of reverse transcriptase regions of the pol gene by RT-PCR and Sanger sequencing. Drug resistance mutation (DRM) interpretation reports the presence of mutations related to protease inhibitors (PIs), Nucleoside reverse-transcriptase inhibitors (NRTI) and Non-nucleoside reverse-transcriptase inhibitors (NNRTI) based on analysis using Stanford HIV database program.@*RESULTS@#DRMs were identified in 35% of patients, among which 46.7% of them showed minor resistance to protease inhibitor with A71V and L10l were the commonest DRMs detected. About 21.4% and 50.0% of patients had mutations to NRTIs and NNRTIs, respectively. CRF01_AE was found to be the predominant HIV-1 subtype.@*CONCLUSIONS@#These findings have served as an initial crucial data in determining the prevalence of transmitted HIV-1 drug resistance for the country. However, more samples from various parts of the country need to be accumulated and analyzed to provide overall HIV-1 drug resistance in the country.

Inadequate Health Literacy on Childhood Immunization and Its Predictors among Antenatal Mothers

Introduction: Outbreak of vaccine preventable disease still persists despite good coverage of immunization in Malaysia. Health literacy on childhood immunization is one of essential factor for the outbreak to happen. Thus, this study determined the predictors of health literacy on childhood immunization among antenatal mother in Seremban, Negeri Sembilan. Methodology: A cross sectional study was conducted among 424 antenatal women using a cluster sampling approach. Antenatal women who were Malaysian and not illiterate were chosen in this study. A self-administered, validated and pretested questionnaire was used to collect data on sociodemographic, socio economic, awareness on immunization, utilization of health care services and health literacy on childhood immunization. The data was analyzed using SPSS version 22.0. Chi Square test was used in bivariate analysis and multiple logistic regression was used to determine the predictors of inadequate health literacy on childhood immunization. Result: Out of 362 respondents, 81.2% were inadequate health literacy. The predictors were maternal education (AOR= 2.608, 95% CI 1.477-4.604), parity (AOR= 1.067, 95% CI 1.103-3.876), residential area (AOR= 2.344, 95% CI 1.184-4.641) and utilization of government hospital (AOR= 2.344, 95% CI 1.184-4.641). Conclusion: Accessibility of health education with regard to immunization need to be strengthen among primigravida, low education and those staying in rural area. In addition, health education also needs to emphasize on the individual that is employed and low economic status with underutilization of government hospital. A simplified education material with interesting pictures and using visual aids help illiterate people for better understanding.

The Correlation of Two Nicotine Dependence Measurement Methods: Fagerstrom Test for Nicotine Dependence (FTND) and Saliva Cotinine among a Group of Muslim Smoker in Malaysia

Introduction: One of the known factors that hindered smoking cessation is nicotine dependence. Measurement of the nicotine dependence is important to better understand cigarette smoking addiction dependence and ways to overcome it. Among methods of nicotine dependence measurement are self-reported Fagerstrom Test for Nicotine Dependence (FTND) and biochemical assessment such as saliva cotinine. Biochemical assessment can be used to measure the accuracy of the self-reported measurement of nicotine dependence. Objective: To explore the correlation between the FTND and the saliva cotinine of the smokers in three different timeline. Methods: A total of 61 male smokers who currently smoke cigarette on daily basis were recruited. The study used the one-group pretest-posttest study design and the data were collected three times. The self-reported measurement were measured by using FTND and the biochemical assessment measured by using saliva cotinine from Saliva Bio oral swab (SOS) with the sensitivity of 0.15ng/ml. Data analysis was conducted by using Pearson correlation. Results: There was a significant association between the FTND score and saliva cotinine level of the smokers at baseline, second and third data collection (p=0.014, p=0.003, p<0.001). Conclusion: Both the self-reported measurement of nicotine dependence and biochemical assessment of the smokers are correlated and it could provide reliable information of the nicotine dependence.

Prevalence and Predictors of Pap Smear Practice among Staff of a Public University in Nilai, Negeri Sembilan

Introduction: The practice of Pap smear has long been an issue worldwide especially in the developing countries. Malaysia National Health and Morbidity Survey IV reported an uptake of 12.8% in 2011. It was found that Malay women has the lowest prevalence of uptake compared to other major ethnicities in the country. The objective of this study is to determine the prevalence of Pap smear practice and its predictors among staff in a public university with majority of Malay ethnicity. Methodology: A cross-sectional study was conducted among female staff in a public university in Nilai, Negeri Sembilan using a self-administered and validated questionnaire. All female staff from the seven faculties and the library were invited to participate. Data were analysed using SPSS version 22 for descriptive and inferential statistics, whereby Multiple Logistic Regression were performed to identify the predictors. Results: One-hundred-and eighty-seven respondents participated this study. The prevalence of Pap smear practice was 65.2%, of which, two-thirds (65.6%) had done it within the past three years. Predictors of the practice were higher parity, attending annual medical check-up, husband’s support and positive attitude towards the test. Conclusion: The prevalence of Pap smear uptake among this population is higher than other studies in Malaysia, however, not all of them have done it regularly within 3 yearly interval as suggested by the World Health Organisation.

Pap Smear Uptake and Its Associated Factors among Orang Asli Women in Selangor

Introduction: Pap smear screening may increase the quality of women’s health through early detection of cervical cancer thus providing a better prognosis for women with cervical cancer. While the benefit of Pap smear screening is well documented, the screening uptake among Malaysian women in general was unsatisfactory with only 47.3% being screened. This study aimed to determine the prevalence of Pap smear uptake and its associated factors among Orang Asli women who lives in rural areas in Selangor. Methods: A cross sectional study was conducted in Hulu Langat and Kuala Langat districts from April to July 2017. Through cluster sampling, five Orang Asli settlements in the two districts were chosen. All women in the selected village aged between 18 to 65 years were invited to participate and interviewed using a structured, pretested questionnaire. Data were analysed using SPSS Version 22. Univariate and bivariate analysis were conducted to identify factors associated with Pap smear uptake among the participants. All hypotheses tests were two-sided and level of significance was set at 0.05. Results: Out of the 147 respondents, 114 (77.6%) had undergone Pap smear for at least once in the past. Women aged more than 35 years (p=0.013) were shown to be significantly more likely to take Pap smear compared to women who were 35 years old and less. There were significant associations between marital status (p<0.001), knowledge (p<0.001), attitude (p<0.001) and use of oral contraceptive (p=0.001) with Pap smear uptake. Conclusion: This study showed a high prevalence of Pap smear uptake among Orang Asli women in Selangor.

Identifications of drug resistance mutations among antiretroviral treatment naive HIV-1 patients in Peninsular Malaysia

Objective To determine drug resistance mutations and the HIV-1 subtypes among antiretroviral treatment naive HIV-1 patients in Peninsular Malaysia. Methods A total of 45 samples from four hospitals that provide HIV viral load services were subjected to the amplification of the protease and two third of reverse transcriptase regions of the pol gene by RT-PCR and Sanger sequencing. Drug resistance mutation (DRM) interpretation reports the presence of mutations related to protease inhibitors (PIs), Nucleoside reverse-transcriptase inhibitors (NRTI) and Non-nucleoside reverse-transcriptase inhibitors (NNRTI) based on analysis using Stanford HIV database program. Results DRMs were identified in 35% of patients, among which 46.7% of them showed minor resistance to protease inhibitor with A71V and L10l were the commonest DRMs detected. About 21.4% and 50.0% of patients had mutations to NRTIs and NNRTIs, respectively. CRF01_AE was found to be the predominant HIV-1 subtype. Conclusions These findings have served as an initial crucial data in determining the prevalence of transmitted HIV-1 drug resistance for the country. However, more samples from various parts of the country need to be accumulated and analyzed to provide overall HIV-1 drug resistance in the country.

Voluntary fasting to control post-Ramadan weight gain among overweight and obese women

This study aimed to examine the effectiveness of an Islamic voluntary fasting intervention to control post-Ramadan weight gain. This study was conducted between July and November 2011. Two weight loss intervention programmes were developed and implemented among groups of overweight or obese Malay women living in the Malaysian cities of Putrajaya and Seremban: a standard programme promoting control of food intake according to national dietary guidelines [group B] and a faith-based programme promoting voluntary fasting in addition to the standard programme [group A]. Participants' dietary practices [i.e., voluntary fasting practices, frequency of fruit/vegetable consumption per week and quantity of carbohydrates/protein consumed per day], body mass index [BMI], blood pressure, fasting blood high-density lipoprotein cholesterol [HDL-C] and total cholesterol [TC]:HDL-C ratio were assessed before Ramadan and three months post-Ramadan. Voluntary fasting practices increased only in group A [P <0.01]. Additionally, the quantity of protein/carbohydrates consumed per day, mean diastolic pressure and TC:HDL-C ratio decreased only in group A [P <0.01, 0.05, 0.02 and <0.01, respectively]. Frequency of fruit/vegetable consumption per week, as well as HDL-C levels, increased only in group A [P = 0.03 and <0.01, respectively]. Although changes in BMI between the groups was not significant [P =0.08], BMI decrease among participants in group A was significant [P <0.01]. Control of post-Ramadan weight gain was more evident in the faith-based intervention group. Healthcare providers should consider faith-based interventions to encourage weight loss during Ramadan and to prevent post-Ramadan weight gain among patients