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In Press
Adebowale, OF.  In Press.   NEED FOR MEASURING VALUES ACQUISITION IN NIGERIAN EDUCATIONAL SYSTEM. . THE PEDAGOGICAL PSYCHOLOGY OF TEACHING AND LEARNINGS’.. , Abuja: National Open University of Nigeria
Oginni, FO, Oladele AO, Adenekan AT, Olabanji JK.  In Press.  Cleft Care in Nigeria: Past, Present and Future. Cleft palate Craniofacial Journal.
Oginni, FO, Braimah RO, Oladejo T, Adenekan AT.  In Press.  Congenital Heterotopic Gastrointestinal Cyst of the Tongue in a New-born: Case Report. International Journal of Oral and Maxillofacial Pathology. 4(3):1.
Oginni, FO, Oladejo T, Braimah RO, Adenekan AT.  In Press.  Sublingual epidermoid cyst in a neonate. Annals of Maxillofacial Surgery. 4(1):1.
2018
Olagunju, A, Schipani A, Bolaji O, Khoo S, Owen A.  2018.  Evaluation of universal versus genotype-guided efavirenz dose reduction in pregnant women using population pharmacokinetic modelling. Journal of Antimicrobial Chemotherapy. 73(1):165-172. AbstractWebsite

Objectives: Lack of data on the pharmacokinetics of efavirenz in pregnant women at the 400 mg reduced dose currently prevents universal roll-out. Population pharmacokinetic modelling was used to explore pharmacokinetic endpoints at 200, 400 and 600 mg daily doses in pregnant women stratified by CYP2B6 metabolic status.

Methods: The analysis was based on 252 plasma efavirenz concentrations from 77 pregnant women (77 sparse, 175 intensive) who received antiretroviral regimens containing 600 mg of efavirenz. The model was developed using NONMEM®. The effect of genetics was investigated and concentration–time courses at steady-state were simulated for individuals (n = 1000 each) classified as CYP2B6 slow, intermediate and fast metabolizers at 200, 400 and 600 mg daily doses.

Results: At a 400 mg reduced dose, predicted mean (90% CI) mid-dose efavirenz concentration (C12) was 2.24 μg/mL (0.89–4.18) in pregnant women classified as slow metabolizers, compared with 0.87 μg/mL (0.34–1.64) in intermediate metabolizers and 0.78 μg/mL (0.30–1.47) in fast metabolizers. C12 was below the 0.47 μg/mL threshold determined within the ENCORE 1 trial in 10% at 400 mg, 4.6% at 600 mg and 3.4% with genotype-guided dosing. The 4.0 μg/mL toxicity threshold was exceeded in 4.6% at 400 mg, 13.5% at 600 mg and 5.2% with genotype-guided dosing.

Conclusions: These data provide context for the ongoing debate about reduction in efavirenz dose to 400 mg during pregnancy and should be interpreted alongside the lower toxicity expected with the lower dose. Additional research is required to investigate genotype-guided dose reduction in pregnant women.

Waitt, C, Olagunju A, Nakalema S, Kyohaire I, Owen A, Lamorde M, Khoo S.  2018.  Plasma and breast milk pharmacokinetics of emtricitabine, tenofovir and lamivudine using dried blood and breast milk spots in nursing African mother–infant pairs. Journal of Antimicrobial Chemotherapy. AbstractDownload (Open Access)

Background: Breast milk transfer of first-line ART from mother to infant is not fully understood.

Objectives: To determine the concentrations of lamivudine, emtricitabine and tenofovir in maternal blood, breast milk and infant blood from breastfeeding mother–infant pairs.

Methods: Intensive pharmacokinetic sampling of maternal dried blood spots (DBS), dried breast milk spots (DBMS) and infant DBS from 30 Ugandan and 29 Nigerian mothers receiving first-line ART and their infants was conducted. DBS and DBMS were collected pre-dose and at 5–6 timepoints up to 12 h following observed dosing. Infant DBS were sampled twice during this period. Lamivudine, emtricitabine and tenofovir were quantified using LC-MS/MS, with non-compartmental analysis to calculate key pharmacokinetic parameters.

Results: Peak concentrations in breast milk from women taking lamivudine and emtricitabine occurred later than in plasma (4–8 h compared with 2 h for lamivudine and 2–4 h for emtricitabine). Consequently, the milk-to-plasma (M:P) ratio of lamivudine taken once daily was 0.95 (0.82–1.15) for AUC0–12, whereas for AUC12–20 this was 3.04 (2.87–4.16). Lamivudine was detectable in 36% (14/39) of infants [median 17.7 (16.3–22.7) ng/mL]. For 200 mg of emtricitabine once daily, the median M:P ratio was 3.01 (2.06–3.38). Three infants (19%) had measurable emtricitabine [median 18.5 (17.6–20.8) ng/mL]. For 300 mg of tenofovir once daily, the median M:P ratio was 0.015 (0–0.03) and no infant had measurable tenofovir concentrations.

Conclusions: Emtricitabine and lamivudine accumulate in breast milk and were detected in breastfeeding infants. In contrast, tenofovir penetrates the breast milk to a small degree, but is undetectable in breastfeeding infants.

2017