Introduction: This audit was performed to monitor the diagnosis and management of chronic kidney disease (CKD) according to the clinical practice guidelines (CPGs) of CKD 2018 in a primary care clinic. Methods: Patients who attended the clinic from April to June 2019 and fulfilled the diagnosis of CKD were included in this study, except for those diagnosed with a urinary tract infection, pregnant women and those on dialysis. These criteria were set based on the CPGs. The standards were set following discussions with the clinic team members with reference to local guidelines, the 2017 United Kingdom National CKD audit and other relevant studies. Results: A total of 384 medical records were included in this audit. Overall, 5 out of 20 criteria for processes and 3 of 8 clinical outcomes for CKD care did not meet the set standards. These included the following: documentation of CKD classification based on albumin category (43.8%); CKD advice (19.0%); dietitian referral (9.1%); nephrologist referral (45.5%); haemoglobin level monitoring (65.7%); overall blood pressure (BP) control (45.3%); BP readings for diabetic kidney disease (DKD) and non-DKD with > 1 g/day of proteinuria (≤ 130/80 mmHg, 37.0%); eGFR reduction of < 25% over the past year (77.2%). Identified problems included the absence of a CKD registry, eGFR and albuminuria reports, and a dedicated team, among other factors. Conclusions: Overall, 8 out of 28 criteria did not meet the standards of CKD care set for this audit. The problems identified in this audit have been addressed. Moreover, strategies have also been formulated to improve the diagnosis and management of CKD in this clinic.

Gelam honey was reported to exhibit anti-oxidative, anti-tumour and anti-inflammatory properties against many types of cancer. The main aim of the present study was to evaluate the effect of Gelam honey on the oxidative stress level of human lung cancer cells. IC50 of Gelam honey was identified by treating A549 cells with different doses of honey (50-200 mg/ml). The cells were divided into four groups and induced with stress using hydrogen peroxide (H2O2) accordingly: control, H2O2, Gelam honey, H2O2 + Gelam honey. After 24 hrs of treatment, oxidative stress markers such as malondialdehyde (MDA) and protein carbonyl, were determined. Induction of oxidative stress significantly increased the levels of MDA (p<0.05) but had no effect on protein carbonyl levels. Treatment with Gelam honey was found to reduce MDA levels (p<0.05) in A549 cells exposed to H2O2 but had no effect on the level of protein carbonyl. Interestingly, Gelam honey treatment alone had no effects on the levels of MDA and protein carbonyl. In conclusion, Gelam honey reduces lipid peroxidation but not protein oxidation in human lung cancer cells subjected to oxidative stress.

Stress-induced premature senescence (SIPS) model is in vitro model of cellular aging. In this study, apoptosis was evaluated in SIPS model and in replicative senescent fibroblasts. We also compared the activity of senescence-associated beta-galactosidase (SA-beta gal) as a biomarker of cellular aging. Our results suggested that SIPS model and senescent fibroblasts might share similar mechanism of aging and apoptosis pathway.