Taseer Feroze Din

All Publications

• A Step towards Achieving Sustainable Otologic Surgery in Low-Resource Settings: A Cost Comparison between Shipping an Otologic versus Microscopic Surgical Setup. Audiology research Thompson, R., Basura, G., Din, T. F., Jayawardena, A. 2022; 12 (4): 388-392

  Abstract

  Background: The advancement of otologic surgery in low-resource settings has been limited by the cost and transport of surgical equipment. This study compared the transportation costs of an otologic microscopic surgical setup (MSS) versus an endoscopic surgical setup (ESS) in low- and low to middle-income countries (LMICs) for surgical teaching. Methods: Dimensions of microscopes, endoscopes and associated surgical instruments were used to calculate shipping costs from Minneapolis, MN, USA to Kenya, Haiti and Sri Lanka. Results: The average cost of internationally shipping the ESS is less than the MSS in Kenya (ESS: USD 1344.03; MSS: USD 20,947.00; p = 0.370), Haiti (ESS: USD 549.11; MSS: USD 1679.00; p < 0.05) and Sri Lanka (ESS: USD 945.38; MSS: USD 8490.57; p = 0.377). Freight shipping was required for the MSS while the ESS can be packed into an international checked bag for USD 35.00 USD. Discussion: The ESS has fewer logistical barriers than the MSS, making the endoscope a feasible option for surgical teaching in LMICs.

  View details for DOI 10.3390/audiolres12040039

  View details for PubMedID 35892665

• Profile of paediatric tuberculosis mastoiditis-a case series SOUTH AFRICAN JOURNAL OF SURGERY Din, T. F., Fagan, J. J., Peer, S. 2022; 60 (1): 62-66

  Abstract

  Tuberculosis (TB) otitis media is an uncommon site of extrapulmonary TB and can primarily present as a complicated TB mastoiditis (TBM). This complication is rare in children, even in TB endemic areas but necessitates early identification as delays can lead to severe morbidities. We describe the clinical characteristics as a case series to raise awareness of the condition, and highlight fundamentals related to diagnosis and management.A retrospective chart review of clinical and radiological information of five children with TBM seen at the Red Cross War Memorial Children's Hospital in Cape Town, South Africa, over the last 5 years. Variables collected included symptomatology, duration of disease, investigations and management.All were under 5 years of age and presented with typical features of acute bacterial mastoiditis. Mean duration of symptoms was 12 days (range 3-30 days). Two children had known TB contacts. Two children had pulmonary involvement, one with miliary TB. CT of the temporal bone demonstrated extensive bony destruction of the petromastoid and demineralised ossicles in all cases. Three children had intracranial extension. Four children demonstrated hearing loss between 30 dB and 83 dB. Necrotising granulomatous inflammation was present in the mastoid specimens in all cases. Confirmatory diagnosis was made via GeneXpert polymerase chain reaction (PCR) (2), Ziehl-Nielson (ZN) stain (1) or a positive TB culture (2). Postoperatively, one patient had normal hearing, two patients had mild conductive hearing loss (CHL), one had mild-moderate CHL and one had profound hearing loss.Delays in identification and management result in marked bony destruction and hearing loss. Radiological and surgical findings typical of TBM, therefore, require tissue sampling from the ear for urgent microscopic, PCR and histologic testing, allowing the avoidance of a mastoidectom. In a TB endemic setting, children with typical findings and necrotising granulomatous inflammation on histology should be considered for prompt commencement of anti-TB therapy while awaiting a definitive diagnosis.

  View details for DOI 10.17159/2078-5151/2022/v60n1a3570

  View details for Web of Science ID 000791794900012

  View details for PubMedID 35451273

• Race and Ethnicity in Otolaryngology Academic Publications. Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery Lindeborg, M., Din, T., Araya-Quezada, C., Lawal, S., Heer, B., Rajaguru, P., Joseph, M., Alkire, B., Fagan, J. 2022: 1945998221084201

  Abstract

  Within otolaryngology, race is commonly included as a study covariate; however, its value in clinical practice is unclear. This study sought to explore how race and ethnicity have been used and applied over time in otolaryngology publications.PubMed database.A systematic review was done to identify original otolaryngology studies between January 1, 1946, and June 25, 2020, with the following search terms: "otolaryngology" AND "race" OR "ethnicity."Of the 1984 yielded studies, 932 were included in the final analysis. Only 2 studies (0.2%) defined race, and 172 (18.5%) gave participants the opportunity to self-identify race. Less than half (n = 322, 43.8%) of studies controlled for confounders. One hundred studies (10.7%) linked race to genetic factors. An overall 564 (60.5%) made conclusions about race, and 232 (24.9%) mentioned that race is relevant for clinical decision making. The majority of studies had first and senior authors from high-income countries (93.9% and 93.8%, respectively). Over time, there was a significant increase in publications that controlled for confounders, the number of race categories used, and studies that highlighted disparities.Race and ethnicity are often poorly defined in otolaryngology publications. Furthermore, publications do not always control for confounding variables or allow participants to self-identify race. On the basis of our findings, we suggest 7 foundational principles that can be used to promote equitable research in otolaryngology publications. Future efforts should focus on incorporating research guidelines for race and ethnicity into journal publication standards.

  View details for DOI 10.1177/01945998221084201

  View details for PubMedID 35259038

• Research Equity in Otolaryngology-Head and Neck Surgery. OTO open Patterson, R. H., Xu, M. J., Okerosi, S., Bhutta, M. F., Der, C., Alkire, B., Njogu, R., Vendra, V., Tamir, S. O., Fagan, J. J. 2021; 5 (2): 2473974X211024145

  Abstract

  Equitable research collaborations benefit the quality and relevance of global otolaryngology-head and neck surgery research. However, analyses of existing global health literature have shown disproportionate representation by foreign authors. To avert this inequity and improve global otolaryngology-head and neck surgery research, we propose a framework that emphasizes local representation and capacity building in research.

  View details for DOI 10.1177/2473974X211024145

  View details for PubMedID 34212124

  View details for PubMedCentralID PMC8216382

• Advancing African otolaryngology and head & neck surgery education and training through virtual academic platforms and multidisciplinary teams CURRENT OPINION IN OTOLARYNGOLOGY & HEAD AND NECK SURGERY Din, T. F., Macharia, C., Harris, T. 2021; 29 (3): 230-234

  Abstract

  To overview the rise of virtual tools to propagate academia and clinical service within Africa, in the field of otolaryngology, propelled by the coronavirus disease 2019 (COVID-19) pandemic.The rise of the COVID-19 virus saw a dramatic reduction in elective surgery and outpatient services with a subsequent reduction in experiential learning for trainees. This has spurred the rising trend to maintain the mission of education and clinical service, virtually. There have been unprecedented levels of international collaboration in the 'pandemic year of 2020' that has seen various platforms conceived to harmonize varying practices from global experts towards the ultimate goal of education propagation and improved patient care. The continent of Africa, amidst its own unique challenges, has boldly stepped into the virtual realm in form of a resident-centred platform coined University Of Cape Town-Africa Virtual ENT, and two multidisciplinary team (MDT) meetings: the African Head and Neck Society Virtual Tumour Board and the African Virtual Cochlear Implant Meeting.The COVID-19 pandemic will have long-lasting effects on clinical practice and training programs globally. This has demanded academicians to re-imagine novel ways to buoy academia and maintain international collaboration in an inexpensive and convenient way to nourish the sacred mission of education and clinical service within our spirited continent.

  View details for DOI 10.1097/MOO.0000000000000712

  View details for Web of Science ID 000643807100010

  View details for PubMedID 33782252

• YO-IFOS Guidelines for Pediatric ENT Surgery during COVID-19: An Overview of Recommendations LARYNGOSCOPE Din, T., Abdalla, T., Chiesa-Estomba, C., Simon, F., Teissier, N., Thomas, I., Fagan, J., Peer, S. 2021; 131 (8): 1876-1883

  Abstract

  To review the literature on pediatric ENT COVID-19 guidelines worldwide, in particular, surgical practice during the pandemic, and to establish a comprehensive set of recommendations.Review.A comprehensive literature review through an independent electronic search of the COVID-19 pandemic in PubMed, Medline, Google, and Google Scholar was performed on April 26-30, 2020. Resources identified comprised of published papers, national and international pediatric ENT society guidelines.Fourteen guidelines fit the inclusion criteria. Key statements were formulated and graded: 1) Strong recommendation (reported by 9 or more/14); 2) Fair recommendation (7-8/14); 3) Weak recommendation (5-6/14); and 4) Expert opinion (2-4/14). Any single source suggestion was included as a comment. Highly scored recommendations included definition of urgent/emergent cases that required surgery; surgery for acute airway obstruction; prompt diagnosis of suspected cancer; and surgical intervention for sepsis following initial first-line medical management. Other well scored recommendations included senior faculty to perform the surgery; the use of open approaches rather than endoscopic ones; and avoidance of powered instruments that would aerosolize virus-loaded tissue. A tracheostomy should be performed on a case by case basis where key technical modifications become necessary.The COVID-19 pandemic will have a profound short and long-term impact on pediatric ENT practice. During this rapidly evolving climate, guidelines have been based on local practice and expert opinion. Until evidence-based practice in the COVID era is established, a comprehensive set of recommendations for pediatric ENT surgical practice based on a review of currently available literature and guidelines, is therefore, appropriate. Laryngoscope, 131:1876-1883, 2021.

  View details for DOI 10.1002/lary.29335

  View details for Web of Science ID 000601595700001

  View details for PubMedID 33325043

• The assessment of quality of life in children with tracheostomies and their families in a low to middle income country (LMIC) INTERNATIONAL JOURNAL OF PEDIATRIC OTORHINOLARYNGOLOGY Din, T. F., McGuire, J., Booth, J., Lytwynchuk, A., Fagan, J. J., Peer, S. 2020; 138: 110319

  Abstract

  The Breatheasy© Tracheostomy Program based at the Red Cross War Memorial Children's Hospital, Cape Town, manages children mostly from poor socio-economic backgrounds. In our resource-limited setting, it is unclear how these families cope with the demands of a tracheostomised child. We aim to assess the quality of life (QOL) of tracheostomised children and their families as the first study of its kind in a low-resource setting.A descriptive, observational study was done to assess the QOL of tracheostomised children managed by the Breatheasy© Program over 10 months. Children with tracheostomies for longer than 6 months, complex syndromic children, and home ventilated children were included. The validated Paediatric Tracheotomy Health Status Instrument (PTHSI) was utilised, where a higher score implied a better outcome.A total of 68 families were recruited. In 57 (85.1%) of the carers, the highest level of education achieved was primary or high school. Twenty-seven (42%) families reported having an annual household income of less than $675 US Dollars (

  View details for DOI 10.1016/j.ijporl.2020.110319

  View details for Web of Science ID 000581172700075

  View details for PubMedID 32882602

• The Unseen Global Burden of Disease OTOLARYNGOLOGY-HEAD AND NECK SURGERY Wiedermann, J., Klug, T., Abhra, T., Alemayehu, B., Sembergman, J., Der, C. 2021; 164 (3): 459-461

  Abstract

  Due to geographic-specific patient and institutional-related barriers to care, data extrapolation and expert opinion on global burden of disease in otolaryngology-head and neck surgery may under- or overestimate the presence and effect of common head and neck conditions. The group of conditions that fail to present to local physicians and/or missed in data extrapolation methods is the unseen burden of disease. This article presents opinions from otolaryngology-head and neck surgery physicians in high- and low/middle-income countries to help explain the contributing factors and ultimately how to use this unseen burden of disease.

  View details for DOI 10.1177/0194599820951464

  View details for Web of Science ID 000563009800001

  View details for PubMedID 32838652

• COVID-19: UCT-Africa Virtual ENT transcends academic silos through videoconferencing academic meetings and ward rounds. South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde Goncalves, N., Din, T. F., Fagan, J. J. 2020; 110 (8): 12996

  View details for PubMedID 32880292

• The Incidence of Atrophic Rhinitis After Endoscopic Sinonasal Surgery Rhinology Online Kamedien, M., Din, T., Lubbe, D. 2020; Vol 3: 100 - 105

  View details for DOI 10.4193/RHINOL/20.034

• UCT-Africa Virtual ENT: A buoyance for academic during Covid-19 Din, T. University of Cape Town, Faculty of Health Sciences. 2020
• The same Africa with a new virus: Three key considerations Din, T. Young African Magazine. 2020
• Clarifying Three Common Misconceptions about Covid-19 in Africa Din, T. Young African Magazine. 2020
• COVID-19: UCT-Africa Virtual ENT changes the face of academic meetings and ward rounds Din, T. Young African Magazine. 2020
• COVID-19: UCT-Africa Virtual ENT transcends academic silos Din, T., Goncalves, N., Fagan, J. ENT and Audiology News. 2020