MUSC The Catalyst
MUSC arial view


MUSCMedical LinksCharleston LinksArchivesCatalyst AdvertisersSeminars and EventsResearch StudiesPublic RelationsResearch GrantsCatalyst PDF FileMUSC home pageCommunity HappeningsCampus NewsApplause

MUSCMedical LinksCharleston LinksArchivesCatalyst AdvertisersSeminars and EventsResearch StudiesPublic RelationsResearch GrantsMUSC home pageCommunity HappeningsCampus NewsApplause


Global Health
Iran: Older than history

Editor's note: Welcome to the Global Health page. The purpose of this feature is to raise awareness of global health issues with an academic spirit to help improve the quality of care provided to patients. E-mail

by Pouya Tahsili-Fahadan, M.D.
Department of Neurosciences
Iran, which means “land of Aryans,” was formerly known as Persia. It is the 18th largest country in the world with more than 70 million people. Persian urban civilization dates back to 7000 BC. Zoroastrian Iran was conquered by the Arabs 14 centuries ago and gradually turned into a country with a majority of Shiite Muslims. Iran got its unofficial independence from the Islamic empire four centuries later. Surprisingly, the language of the country remained Persian. In the 20th century Iran experienced two revolutions: the first, a constitutional revolution leading to parliamentarism in 1906; and the second revolution in 1979 which ended 25 centuries of monarchy.

The Khaju Bridge, located in Isfahan, was built in 1667.

The major cities include Tehran, the capital and one of the most polluted cities in the world with a population of more than 13 million; Isfahan, the cultural center and former capital that houses several UNESCO (United Nations Educational, Scientific and Cultural Organization) world heritage sites; Mashhad, a religious city in the Northeast; Shiraz, famous for its wine and poets, located near the historic capital Persepolis; and Tabriz, the capital of Eastern Azerbayjan state.
Medical education and research have a long history in Iran. Examples include the founding of Gondeshapour University in the fifth century, a description of a cesarean section in the epic, Shahnameh, written by Ferdowsi in the 10th century, the discovery of ethanol by Rhazes in the 10th century, and the writing of “Canon in Medicine” by Avicenna in the 11th century. Modern clinical medicine started in Iran with the establishment of the Dar-ol-Fonoun school in 1851 followed by the University of Tehran in 1934.
Naghsh-e Jahan Square, officially known as Imam Square, is at the center of Isfahan, Iran.

Biomedical research slowed significantly after the 1979 revolution which resulted in a massive immigration of scholars and young investigators to other countries. Also contributing to this “brain drain” were the eight-year war between Iran and Iraq, the many political crises between Iran and western nations leading to 30 years of sanctions against the country, and insufficient investment in research (less than 0.5 percent of gross domestic product). However, medical research accelerated significantly after the “reform government” took office in 1998. Nanotechnology, biotechnology, pharmaceutical sciences, neurosciences and stem cell research are among the fastest growing fields. In clinical sciences and research, hematology (especially bone marrow transplantation), rheumatology, kidney, liver and heart transplantation, and gastroenterology have been very successful internationally. Interestingly, Iran has one of the highest global rates of rhinoplasty.

Clinician’s corner
A 30-year-old woman of Middle-Eastern origins presents with a one -year history of relapsing painful oral and genital ulcers that heal spontaneously, pain and swelling of knees and blurred vision. Physical examination reveals multiple large elevated round aphthous ulcers in oral cavity, scars of previous genital ulcers as well as elevated tender nodules on the anterior side of legs. Red injection of eyes is noticed and further examination indicates uveitis. Pethergy reaction test is positive. Two uncles of the patient have experienced blindness and stroke in their 30’s that were treated with corticosteroids and cyclosporine. What is the most likely diagnosis?
A. Reiter syndrome           
B. Behcet disease
C. Rheumatoid arthritis    
D. Isolated CNS vasculitis
E. Lupus

The correct answer is B. Behcet disease is a rare vasculitis more commonly seen in people of Middle- Eastern origin (although may affect people from all origins) that most commonly affects oral cavity and genitalia with painful ulcers that heal spontaneously.  Aphthous ulcers are seen in normal people but are more frequent and larger in Behcet patients. The above described skin lesion is erythema nodosum. Involvement of eyes may lead to blindness and vasculitis of cerebral vessles may result in stroke. Although the etiology is still unclear, it is most probably an autoimmune disorder. Manifestations may be more severe in males and elderly. Diagnostic criteria includes: aphthous ulcer less than 3 times a year plus two of genital ulcers, ophthalmic involvement, dermatologic manifesta-tions and positive pathergy test. Treatment includes topical corticosteroids in the form of ointments, mouthwash and eye-drops, systemic steroids and immunomodulators.

World AIDS Day

  • AIDS Testing: 9 a.m. - 12:30 p.m.,  Nov. 30, Colbert Education Center & Library lobby.
  • Red Ribbon Sale: Noon, Dec. 1, Colbert Education Center & Library lobby.
  • Seminar: 3 p.m., Dec. 1,  Basic Science Building Auditorium. Dr. Paul Volberding pioneered studies of the drug AZT to treat patients with HIV and AIDS.
  • Candlelight Vigil Walk, 5 p.m., Dec. 1,  Marion Square.

International ‘Sweet and Savory’ Bake Sale
11 a.m. - 1:30 p.m., Dec. 8  at the University Hospital and Colbert Education Center & Library.

International James Island County Park Festival of Lights Trip
Dec. 12. Meet at Jonathan Lucas bus stop at 6:30 p.m.

International New Year’s Lunch
Noon - 1 p.m., Jan. 13, Harper Student Center.


Friday, Nov. 27, 2009

The Catalyst Online is published weekly by the MUSC Office of Public Relations for the faculty, employees and students of the Medical University of South Carolina. The Catalyst Online editor, Kim Draughn, can be reached at 792-4107 or by email, Editorial copy can be submitted to The Catalyst Online and to The Catalyst in print by fax, 792-6723, or by email to To place an ad in The Catalyst hardcopy, call Island Publications at 849-1778, ext. 201.