Syrian troops in tanks have stormed the flashpoint city of Hama, killing and wounding scores of people in a barrage of shelling and gunfire that left bodies scattered in the streets.
Residents shouted "God is great!" and threw firebombs and stones at the tanks as they pushed through the city before dawn on Sunday.
"It's a massacre, they want to break Hama before the month of Ramadan," an eyewitness who identified himself by his first name, Ahmed, told the Associated Press by telephone.
Hospitals were overwhelmed with casualties and were seeking blood donations, he said.
Activists have predicted that demonstrations will escalate during Ramadan, which starts on Monday, as protesters and government forces try to use the Muslim holy month to tip the balance of the uprising that began in March in their favour.
Ahmed, a Hama resident, said he saw up to 12 people shot dead in the streets in a district known as the Baath neighbourhood. Most had been shot in the chest and head, he said.
"Troops entered Hama at dawn today," another resident told AP by telephone. "We woke up to this news, they are firing from their machine guns randomly and there are many casualties."
A doctor, who preferred to remain anonymous, told Reuters that the city's Badr, al-Horani and Hikmeh hospitals had received 24 bodies.
There were scores of wounded people and a shortage of blood for transfusions, he said by telephone from the city, which has a population of around 700,000.
"Tanks are attacking from four directions. They are firing their heavy machine guns randomly and overrunning makeshift roadblocks erected by the inhabitants," the doctor said. Machine gun fire could be heard in background as he spoke.
"There are bodies uncollected in the streets," said another resident, adding that army snipers had positioned themselves on the roofs of the state-owned electricity company and the main prison.
Tank shells were falling at the rate of four a minute in and around northern Hama, residents said, and electricity and water supplies to the main neighbourhoods had been cut off - a tactic used regularly by the military when storming towns.
During Ramadan, Muslims throng mosques for special night prayers after breaking their daily dawn-to-dusk fast. The gatherings could trigger major protests throughout the predominantly Sunni country and activists say authorities are moving to try to ensure that does not happen.
An estimated 1,600 civilians have died in the crackdown on the largely peaceful protests against President Bashar al-Assad's regime since the uprising began. Most of the dead were killed in shootings by security forces at anti-government rallies.
Hama, about 130 miles (210 kilometres) north of Damascus, has become one of the hottest centres of the demonstrations. In early June, security forces shot dead 65 people there, and since then it has fallen out of government control, with protesters holding the streets and government forces ringing the city and conducting overnight raids.
The city has a history of dissent against the Assad dynasty. In 1982, Assad's late father, Hafez al-Assad, ordered his brother to quell a rebellion by Syrian members of the conservative Muslim Brotherhood movement. The city was sealed off before air strikes destroyed parts of the city. As many as 25,000 people, human rights groups say.
The real number may never be known. Then, as now, reporters were not allowed to reach the area.
The London-based Syrian Observatory for Human Rights said it had compiled the names of 13 dead from hospitals and residents in Hama, but the figure could not be independently confirmed. The Syria-based Local Coordination Committees said it had the names of four victims, but thatthere were more bodies still to be identified.
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