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All Journal Molecular and Cellular Biomedical Sciences (MCBS) Acta Pharmaciae Indonesia : Acta Pharm Indo
Ramadhan, Andika Yusuf
Unknown Affiliation
Biochemistry, Genetics & Molecular Biology Dentistry Immunology & microbiology Medicine & Pharmacology Neuroscience

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Molecular Adaptation of Cardiac Remodeling in Metabolic Syndrome: Focus on AMPK, SIRT1 and PGC-1a Ramadhan, Andika Yusuf; Soetikno, Vivian
Molecular and Cellular Biomedical Sciences Vol 8, No 1 (2024)
Publisher : Cell and BioPharmaceutical Institute

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21705/mcbs.v8i1.367

Abstract

Obesity, lack of physical activity, and genetic predisposition might play a pivotal role in pathogenesis of metabolic syndrome. Cardiac function alteration including hemodynamic changes, contractility function, arrhythmia, and cellular respiratory function, might happen due to chronic condition in metabolic syndrome. Insulin resistance, neurohormonal activation and chronic inflammation might contribute to these changes. Cardiomyocyte had capabilities to adapt from these abnormalities, one of them is the activation of cellular pathway to resist cardiac injury from metabolic syndrome. This molecular pathway involves three proteins, including AMP-activated protein kinase (AMPK), sirtuin-1 (SIRT1) and peroxisome proliferator-activated receptor γ coactivator-α (PGC-1α). The aim of this narrative review is to elucidate role of AMPK, SIRT1, and PGC-1α in cardiac adaptation against cardiac dysfunction in metabolic syndrome. AMPK, SIRT-1, and PGC-1α contribute to adapt and to repair the cardiac injury resulting from celullar and mechanical stress from metabolic syndrome and prevent cardiac remodeling event. Several pathological events, such as insulin resistance, induce alteration of switching energy fuel to the heart, causing cardiomyocte to rely on glucose metabolism and lipotoxicity, leading to damages of cardiomyocyte through reactive oxygen species (ROS) generation and lipid peroxidation. Increase of ROS promotes cardiac injury followed by necrotic and apoptotic events. AMPK, SIRT1, and PGC-1α act as cardioprotector molecule against metabolic syndrome insults to several mechanism such as: AMPK play role as counter act of lipotoxicity and insulin resistance through increasing insulin sensitivity and regulate redox reaction. SIRT1 plays role in regulating apoptotic genes and PGC-1α repairs cardiac fuel sources. Activation of AMPK/SIRT1/PGC-1α prevent cardiac remodeling due to metabolic syndrome by increasing insulin sensitivity, increases mitochondrial biogenesis and reduce pro-apoptotic signals in cardiomyocte.Keywords: AMPK/SIRT1/PGC-α, cardiac remodeling, metabolic syndrome
The Prospect of Probiotics to Treat Metabolic Syndrome Ramadhan, Andika Yusuf; Rosdiana, Dewi Selvina
Molecular and Cellular Biomedical Sciences Vol 8, No 2 (2024)
Publisher : Cell and BioPharmaceutical Institute

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21705/mcbs.v8i2.425

Abstract

Metabolic syndrome remains as a major health problem in the world today, with a prevalence of 23.4% in people aged 26-82 years. A high-fat, high-carbohydrate diet and lack of physical activity are considered as one of the triggers for metabolic syndrome. Dysbiosis is a condition where there is an imbalance between pathogenic and non-pathogenic bacteria in the human gut. Currently, an association has been found between dysbiosis and metabolic syndrome. Dysbiosis causes the generation of fermentation products in the form of active metabolites that can modulate hormones and other physiological functions. In metabolic syndrome, low-grade inflammation, energy metabolism, and disruption of the gut brain axis are thought to be the main mechanisms of the development of metabolic syndrome due to dysbiosis. Probiotics may be a promising therapeutic agent in the treatment of metabolic syndrome, by improving dysbiosis to eubiosis. Based on previously conducted clinical trials, it is currently known that probiotics can improve lipid profiles, fasting blood glucose, homeostatic model assessment for insulin resistance (HOMA-IR), vascular cell adhesion molecule 1 (VCAM-1), glucagon-like peptide-1 (GLP-1), peptide YY (PYY), and body mass index (BMI). However, the results found are still varied, so a dose ranging study is needed to determine the duration, bacterial composition and dose of probiotics as a therapeutic agent for metabolic syndrome. Keywords: insulin resistance, dysbiosis, gut-brain axis
Potential drug-drug interactions in elderly patients in a renal ward: a single-center retrospective study in Pakistan Ahmad, Nouman; Ramadhan, Andika Yusuf; Mahmood, Asif; Faisal, Shah
Acta Pharmaciae Indonesia Vol 12 No 2 (2024): Acta Pharmaciae Indonesia: Acta Pharm Indo
Publisher : Pharmacy Department, Faculty of Health Sciences, Jenderal Soedirman University, Purwokerto, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20884/1.api.2024.12.2.15510

Abstract

Background: The increasing prevalence of kidney disease among elderly populations has led to a rise in potential drug-drug interactions (pDDIs), particularly due to widespread polypharmacy use in this demographic. Objective: This study aims to retrospectively analyze pDDIs and identify their prevalence and associated factors among elderly patients in a renal ward. Methods: This retrospective observational study was conducted at Saidu Group of Teaching Hospital in Swat, Pakistan, from January to December 2022. Data were obtained from the Patients Records Office using a conventional paper-based record system. A sample of 43 elderly patients (age ≥60 years) was selected through consecutive sampling. Drug interactions were assessed using freely available online tools: Drugs.com and Medscape Drug Checker, selected for their user-friendly accessibility and suitability in resource-limited settings. Results: Among the 43 elderly subjects with balanced gender distribution, the mean age was 66.53 ± 7.68 years. Comorbidities were present in 74.4% of patients, and each patient was prescribed an average of 4.58 medications. According to Medscape, 62.79% of patients experienced one or more potential drug interactions, while Drugs.com identified interactions in 67.44% of cases. Notably, 15% of these interactions were classified as high-risk by both tools. Logistic regression analysis indicated a significantly higher risk of potential drug interactions with increasing numbers of prescribed medications (OR = 4.515, p = 0.033). Conclusion: This study identified a high prevalence of pDDIs among elderly patients with kidney disease in Pakistan. The majority had comorbidities necessitating multiple medications, thereby increasing the risk of adverse drug reactions (ADRs). Mitigating these risks requires accurate prescribing practices, reliable electronic surveillance systems, and clinical pharmacist support.
Co-Authors Ahmad, Nouman Mahmood, Asif Rosdiana, Dewi Selvina Shah Faisal Vivian Soetikno