From Tehran to Dallas: Jafar Forghani, MD Internist-Rheumatologist

1. From Tehran to Dallas Jafar Forghani, MD Internist-Rheumatologist Iran University of Medical Sciences (IUMS) Tehran, Iran March 17, 2006

2. Jafar Forghani,MD • Born in Abadan, Iran 1945 • MD degree from Isfahan Medical school: 1963-1970 • Internship @ Malden Hosp.,Malden, MA: 1973-1974 • Medical residencies + Rheumatology fellowship @ Cleveland Clinic, Cleveland, OH: 1974-1978 • Prof. of medicine , Dep. Internal Med Head, division of Rehumatology @ IUMS: 1978- present • Member: Iranian Board of Internal Medicine Iranian Board of Rheumatology Iranian Rheumatology Association

3. From Tehran to Dallas • Iran & Tehran • Medical schools in Iran • Internal medicine & rheumatology in Iran • Iran University of Medical Sciences (Tehran) • Examples of patients and quizzes for medical residents • Sabbatical study in Dallas

4. Iran-Persia The Aryans came about 2000 BC and split into two main groups, the Medes and the Persians. The Persian Empire founded (c.550 BC) by Cyrus the Great. It was succeeded, after a period of Greek and Parthian rule, by the Sassanid in the early 3d century (AD). Iran (Eran, Arynam, land of Aryans)

5. Achaemenid Empire(500 B.C.) The Achaemenid Persians of central Iran ruled an empire which comprised Iran, Mesopotamia, Syria, Egypt, and parts of Asia Minor and India from the 6th to the 4th century B.C.

6. The Achaemenids ceremonial capital was Persepolis in southern Iran founded by King Darius the Great (522-486 B.C.)

7. XPa Trilingual 1 Gate of Xerxes North Door Jamb, West Doorway | Elamite Inscription | Old Persian Inscription | Akkadian Inscription |

8. Cyrus II = Cyrus(Koresh) the great Length: 22.86 cm Cyrus Cylinder This cylinder has sometimes been described as the 'first charter of human rights'

9. Text of the declaration(Cyrus Cylinder) I am Cyrus, King of Persia, great king, mighty king, King of Babylon, king of the land of Sumer and Akad, King of ......, king of the four quarters of Earth, son of Cambysis (Kambujiye), great king, king of Anshan, grandson of Cyrus (Kurosh),

10. Text of the declaration(Cyrus Cylinder) As to the inhabitants of Babylon who against the will of the gods were enslaved, I abolished the corvee which was against their social standing, I freed all slaves. I brought relief to their dilapidated housing, putting thus an end to their misfortunes and slavery

11. Now that I put the crown of kingdom of Iran, Babylon, and the nations of the four directions on the head with the help of (Ahura) Mazda, I announce that I will respect the traditions, customs and religions of the nations of my empire and never let any of my governors and subordinates look down on or insult them until I am alive. I never let anyone oppress any others, and if it occurs , I will take his or her right back and penalize the oppressor. And until I am the monarch, I will never let anyone take possession of movable and landed properties of the others by force or without compensation. Until I am alive, I prevent unpaid, forced labor.

12. Text of the declaration(Cyrus Cylinder) To day, I announce that everyone is free to choose a religion. People are free to live in all regions and take up a job provided that they never violate other's rights. No one could be penalized for his or her relatives‘ faults. I prevent slavery and my governors and subordinates are obliged to prohibit exchanging men and women as slaves within their own ruling domains. Such a traditions should be exterminated the world over ......

13. Persepolis was burned by Alexander the great in 331 B.C. Only the columns, stairways, and door jambs of its great palaces survived the fire. The stairways, adorned with reliefs representing the king, his court, and delegates of his empire bringing gifts, demonstrate the might of the Persian monarch.

14. Perspolis – 600 miles south of Tehran The Achaemenids ceremonial capital was Persepolis in southern Iran founded by King Darius the Great (522-486 B.C.)

16. IRAN: Persepolis - Portico of the "Hundred-columned Hall" of Darius (ca. 520 B.C.). The body of a colossal bull from the gateway can be seen at the lower left.

17. U.S.A.: Chicago - Colossal bull head from Persepolis, as restored and installed in the Iranian Hall of the Oriental Institute Museum

18. Area:1.648 million sq km Slightly larger than Alaska Land boundaries: total: 5,440 km Border countries: Afghanistan 936 km, Armenia 35 km, Azerbaijan-proper 432 km Azerbaijan-Naxcivan exclave 179 km, Iraq 1,458 km, Pakistan 909 km, Turkey 499 km, Turkmenistan 992 km Population: ~ 70 million

19. Milad Tower: Tehran Azadi Square: Tehran Tehran Population: 10 to 12 millions

28. Isfahan (Esfahan)= half the world Naghsh-e-Jahan (Shah) square

29. Sheikh Lotfollah mosque - Isfahan

31. Medical Schools in Iran

32. Tehran University : 1934 Iran University of Medical Sciences: 1974

33. Internal Medicine in Iran • 4 year program > 3 y. program > 4 y. program • Admission through national entrance exams • Promotion by universities evaluations + national exam • Board eligible internists get license to practice • National Board of Internal Medicine • Board certified internists may go to subspecialty programs or employed as medical staff in universities • Currently there are 7 approved subspecialty programs: Card., Endo., GI., Hem-Onc., Nephro., Pulm., and Rheum. (Infectious disease – straight from MD)

34. Morning Report Internal Medicine Hazrat Rasool Hospital

37. Medical staff – Internal Medicine, Hazrat Rasool Hospital

40. Rheumatology

41. Rheumatology in Iran • Fellowship programs started in 1983 • 2 years clinical programs in 5 centers ( 3 in Tehran, 1 in Shiraz, and 1 in Mashad) • Admission through national entrance exams (written and oral)- 11 positions each year • Subspecialty Board of Rheumatology exam after completion of 2 years fellowship

42. Hazrat Rasool Hospital- Rheumatology staff and fellows

43. Rheumatology fellows waiting for oral exam (Board)

44. Common and uncommon rheumatic diseases in Iran • Interesting cases • Quizzes

46. A 25 year old female presented with problem with walking

48. Unilateral sacroiliitis(Brucellosis) Brucella spondylitis

50. Behcet’s Disease