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Special issue – HIV/AIDS

  From the desk of editor in chief
Dr KK Aggarwal

Padma Shri and Dr B C Roy National Awardee
Dr KK Aggarwal
President, Heart Care Foundation of India; Sr Consultant Physician, Cardiologist and Dean Medical Education Moolchand Medcity; Chairman Ethical Committee Delhi Medical Council; Chairman (Delhi Chapter) International Medical Sciences Academy; Hony Director IMA AKN Sinha Institute (08–09); Hony Finance Secretary National IMA (07–08); Chairman IMA Academy of Medical Specialties (06–07); President Delhi Medical Association (05–06), President IMA New Delhi Branch (94–95, 02–04); Editor in Chief IJCP Group of Publications & Hony. Visiting Professor (Clinical Research) DIPSAR

  Editorial ...

30th November 2010, Tuesday

For regular emedinews updates follow at www.twitter.com/DrKKAggarwal

Exposure to HIV, Hepatitis B and or Hepatitis C infected blood

Although more than 200 different diseases can be transmitted from exposure to blood, the most serious infections are hepatitis B virus (HBV), hepatitis C virus (HCV), and HIV. Co infection with HIV and hepatitis C infection or HIV with hepatitis B infection is also common since all three infections share similar routes of transmission. Approximately 30 percent of patients who are HIV infected are also co infected with HCV and 10% with chronic hepatitis B infection. The prevalence also depends on the route of transmission. Hepatitis C virus seroprevalence in HIV infected patients is seen in up to 73 % in intravenous drug users and 4 % in patients considered to be at low risk.

Injection drug users usually acquire hepatitis C virus before HIV infection while men who have sex with men typically are infected with HIV before they acquire hepatitis C virus infection. Hepatitis C virus is transmitted efficiently via percutaneous routes, so seroprevalence rates are highest in intravenous drug users. Injection drug use is currently the leading route of HCV transmission.


In order to be exposed to a blood-borne pathogen, one must have contact with virus containing blood, a visibly bloody fluid (sputum or urine containing blood), or another bodily fluid (semen or vaginal secretions). The blood or fluid must come in direct contact with some part of the body. A virus can enter the body through the bloodstream, open skin, or mucous membranes (eye, mouth, or genitals). Contact with intact skin (without new cuts, scrapes, or rashes) poses no risk of infection. Thus, exposure to a blood–borne pathogen is possible after a skin injury such as a needle stick or cut with a sharp object or contact with a mucous membrane (including exposure through sexual intercourse, especially if an ulcer is present or vaginal tissues are injured) or non intact skin.

Hepatitis B virus (HBV) is the most infectious virus that can be transmitted through the blood or bodily fluids. A healthcare worker who is stuck with a needle containing blood infected with hepatitis B virus has between 6 to 30% chance of developing hepatitis B. The risk of hepatitis C virus and HIV in the same situation is 1.8 and 0.3%, respectively. Hepatitis B virus gets transmitted by percutaneous and mucosal exposures and human bites. It has also been transmitted by fomites such as finger stick blood sugar check, multi dose medication vials, jet gun injectors, and endoscopes. HBV can survive on counter tops for seven days and remain capable of causing infection. Transmission of hepatitis C virus from blood splashes to the conjunctiva has been described. Hepatitis C virus has been demonstrated to survive on environmental surfaces for at least 16 hours but not 4 or 7 days. 

Dr KK Aggarwal
Editor in Chief
drkkaggarwal Dr K K Aggarwal on Twitter
Krishan Kumar Aggarwal Dr k k Aggarwal on Facebook
  HIV/AIDS Update

What to do after blood or body fluid exposure?

  1. The first and most important step after being exposed to blood or bodily fluids is to wash the area well with soap and water. One can clean small wounds and punctures with an antiseptic such as an alcohol–based hand gel, since alcohol kills HIV, hepatitis B virus, and hepatitis C virus. For mucosal surfaces (mouth, nose), the area should be flushed with copious amounts of water. Eyes should be flushed with saline or water. There is no evidence that expressing fluid by squeezing the wound will further reduce the risk of blood borne infection.
  2. The risk of becoming infected with hepatitis B is greater than the risk of becoming infected with other viruses. Hepatitis vaccine should be given to anyone who is exposed to blood, even if the blood is not known to carry HBV. The vaccine should be given at the time of exposure, and repeated one month and six months later to fully protect you against future infection. If a person is already vaccinated he or she should receive a single booster dose of the vaccine after being exposed to potentially infected blood.
  3. If the exposed blood is positive for HBV and the exposed person is unvaccinated, treatment with hepatitis B immunoglobulins (HBIG) is recommended. It contains antibodies that provide temporary protection against the infection. HBIG is an injection, which should be given as soon as possible after exposure, preferably within 24 hours. A dose of hepatitis B vaccine is recommended at the same time. HBIG is not needed if the exposed person is already fully vaccinated. If not sure about the vaccine status do a blood test to determine if there are adequate levels of antibodies to the virus. If antibody levels are low, HBIG and the series of three Hep B vaccines are recommended.
  4. Hepatitis C virus can cause chronic liver disease. There is no vaccine for it. Blood tests should be done immediately after exposure to measure the liver function and test for the presence of hepatitis C; the tests should be repeated after 4 to 6 weeks and again after 4 to 6 months, or sooner if symptoms of hepatitis develop.
  5. For HIV, treatments are available to reduce the risk of becoming infected with HIV after exposure. The use of an anti HIV drug zidovudine, can reduce the risk of healthcare workers becoming infected with HIV by 81 %. This means that the number of people who are likely to become infected from a needle stick that contains HIV infected blood can be reduced from 3 in 1000 to 0.5 in 1000 as a result of taking anti HIV medication.
  6. The risk of becoming infected with HIV as a result of exposure to trauma and rape is even lower than the risk of infection after a needle stick. All rape victims should be given anti–HIV drugs.
  7. All women of childbearing age should be tested for pregnancy before beginning treatment, although being pregnant does not mean that a woman cannot take anti-HIV medications.
  8. Anyone who is exposed to potentially infected blood or bodily fluids should be tested for HIV at the time of exposure (baseline) and at six weeks, three months, and six months post exposure.
  9. Experts from the US CDC recommend use of drugs to reduce the risk of HIV infection if all of the following criteria are met:
    • Exposure occurred < 72 hours previously
    • One or more of the following areas were exposed: the vagina, rectum, eye, mouth, or other mucous membrane, open skin, through the skin (e.g., from a sharp or needle)
    • One or more of the following bodily fluids was involved in the exposure: blood, semen, vaginal secretions, rectal secretions, breast milk, or any body fluid that is visibly contaminated with blood
  10. The CDC recommends not using preventive treatment when: the exposure occurred > 72 hours prior; when intact skin was exposed; or when the bodily fluid is urine, nasal secretions, saliva, sweat, or tears, and is not visibly contaminated with blood.
  11. Anyone who is exposed to blood or bodily fluids should consult with doctor if symptoms of fever, swollen lymph nodes (glands), sore throat, skin lesions, muscle or joint pain, diarrhea, headache, nausea/vomiting, or weight loss develop. The usual time from HIV exposure to the first symptoms of HIV is 2 to 4 weeks.

Treatment regimen

  1. Anti–HIV preventive treatments should be started as soon as possible after exposure, within a few hours rather than days.
  2. Preventive treatment is not likely to be helpful and is not recommended if > 72 hours have elapsed since exposure.
  3. The CDC recommends a combination of 2 or 3 medications to prevent developing HIV after exposure.
  4. Four weeks of treatment is generally recommended.

Follow up

  1. For people who are given the hepatitis vaccine, it is important to return for the second and third injection to be completely protected.
  2. People exposed to a blood–borne infection during sex are often tested for other sexually transmitted diseases. Tests for syphilis and cultures for gonorrhea and Chlamydia are usually performed immediately after exposure and four to six weeks later.

Protecting others after exposure

  1. Precautions are important during the first three months after exposure, when most people who are infected with HIV become antibody positive.
  2. Precautions include abstaining from sexual intercourse or using condoms every time. Condoms reduce, but do not completely eliminate, the chances of transmitting hepatitis B, hepatitis C, or HIV infection to others.
  3. Women who have been exposed to blood or body fluids from a person known to be infected should avoid becoming pregnant during this time.
  4. Individuals who were exposed to HIV infected fluids should not donate blood, plasma, organs, tissue, or semen during the follow up period.
  5. Women who are breastfeeding should stop breastfeeding due to the risk of passing the infection to their child.


1. When to suspect a patient is HIV positive?

Ans. Always make a habit of asking history of high risk sexual behavior, sexual orientation and sexual practices from a patient. High risk patients need HIV testing.

2. What is Opt out policy?

Ans. In the US, HIV testing is done compulsorily unless the patients themselves opt out. In India, this policy is not applicable though it is under consideration with NACO.

3. What is acute retroviral syndrome?

Ans. It is a phase of acute viremia usually seen 3 to 4 weeks after exposure to HIV infected blood/secretion. The patients present with fever, rash, enlarged lymph nodes. The viral load is very high at this stage. It is controversial whether or not to treat such cases.

4. How is HIV testing done?

Ans. Screening for HIV is done either by ELISA or by Rapid Testing. Unless 20 samples are available at a time, most laboratories do rapid testing. Both technologies have equal sensitivity.

5. What is HIV testing policy?

Ans. If the first ELISA or rapid testing is negative, no further testing is done. However, if the first is positive, second testing is done by a different method.

  • If two tests are positive and clinically patient has AIDS related illness, treatment can be started. However, if the patient is asymptomatic, if two tests are positive, then third test by Elisa or Rapid technology needs to be done.
  • Unless all three are positive, patient is not labeled as HIV positive.
  • If the first is positive and second is negative, the patient is not labeled positive. In such cases, one may go for Weston blot test.
  Quote of the Day

(By Dr GM Singh)

The love of a family is life's greatest blessing

    Photo Feature

 Workshop on Kidney Transplant

"Daily dialysis is better than 3 dialyses a week and 3 dialyses are better than 2 dialyses a week." This was the conclusion of a panel of experts in a symposium on Kidney Transplant organized at Moolchand Medicity by IMSA Delhi Chapter, IMA New Delhi Branch, IMA Janak Puri Branch, Moolchand Board of Medical Education and eMedinewS.

Dr K K Aggarwal
    National News

Certificate courses in 2D and 3D Echocardiography/Fellowship Diploma in non invasive cardiology

Contact Dr KK Aggarwal, Moolchand Medcity, email:emedinews@gmail.com

6L dying of inhaling second-hand smoke annually

Second–hand smoke (SHS) is killing six lakhs annually, including 1.65 lakh children before they reach their fifth birthday. A study by the World Health Organization (WHO) in 192 countries –– the first of its kind to assess all deaths caused by SHS has found that tobacco kills nearly 5.7 millions globally every year, including 5.1 millions who die from their own smoking. The rest perish, thanks to passive smoking. Only 7.4% of global population lives in countries that boast of laws to prevent smoking in public places. Though India has banned smoking in public places, its stringent implementation has left a lot to be desired. India recently released its Global Adult Tobacco Survey (GATS), which found that despite a ban on public smoking –– about five in 10 adults (52.3%) were exposed to SHS at home and 29% at public places –– mainly in public transport and restaurants. (Source: The Times of India, Nov 27, 2010)

    International News

(Dr Monica and Brahm Vasudev)

Heparin, aspirin during pregnancy safe

Only one of 21 women with a history of early preeclampsia had recurrence of the condition when treated with heparin and aspirin during a subsequent pregnancy, according to a poster presentation at the American Society of Nephrology’s meeting.

Once–monthly epo receptor activator better in predialysis CKD

More than half of patients with predialysis chronic kidney disease maintained hemoglobin levels when switched from erythropoiesis–stimulating agents to a once–monthly epo receptor activator, according to data from two studies presented at the American Society of Nephrology’s meeting.

Elderly with mild hyponatremia at increased risk for falls

Elderly patients who are even mildly hyponatremic have a significantly higher risk for falls and fractures than those with normal sodium levels," according to research presented during the American Society of Nephrology’s annual meeting.

NIH dialysis study finds six–day-a–week treatment more effective

The conventional frequency of dialysis is three times a week, but a new study suggests that six times a week may be better. (Griffin P. Rodgers, director of the NIH National Institute of Diabetes and Digestive and Kidney Diseases)

    Infertility Update

Dr. Kaberi Banerjee, Director Precious Baby Foundation

What is ICSI?

ICSI stands for intracytoplasmic sperm injection. It is used in cases of very low sperm counts. The single sperm after preparation is injected in the oocyte. The sperm can be ejaculated or aspirated from testis or epididymis. This is an advanced ART procedure and technically demanding.

What are the risks of IVF?

Ovarian hyperstimulation, ectopic pregnancy, multiple pregnancy are seen occasionally. Risks at oocyte retrieval of bowel and vascular injuries are also mentioned in the literature.

For queries contact: banerjee.kaberi@gmail.com

    Medicine Update

Dr. Neelam Mohan, Director Pediatric Gastroenterology, Hepatology and Liver Transplantation, Medanta – The Medicity

Tooth Decay in Children

Tooth decay develops when a child's teeth and gums are exposed to any liquids or foods other than water for long periods. The most common way this happens is when parents put their children to bed with a bottle of formula, milk, juice, soft drinks, sugar water, or sugared drinks. It can also occur when children are allowed to drink from a sippy cup, suck on a bottle, or breastfeed for long periods during the day or night.

    Medicolegal Update

Dr Sudhir Gupta, Associate Professor, Forensic Medicine & Toxicology, AIIMS

What is WMA Statement on In–Vitro Fertilization and Embryo Transplantation?

The WMA urges physicians to act ethically and with appropriate respect for the health of the prospective mother and for the embryo from the beginning of life. To assist physicians in recognizing and following their ethical obligations, the WMA has promulgated this statement. From the ethical and scientific viewpoint, medical assistance in human reproduction is justified in all cases of infertility which do not respond to classical drug or surgical treatment with specific reference to: Immunological incompatibility, Irreversible obstacle to contact between male and female gametes, Infertility for unknown cause.

  • In all these cases, the physician can only act with the full informed consent of donors and recipients.
  • The physician must always act in the best interest of the child to be born of the procedure.
  • It is the physician’s responsibility to provide the patients, at their own level of comprehension, with sufficient information about the purpose, methods, risks, inconveniences and disappointments of the procedure, and to obtain from the patients their informed consent to the procedure.
  • As in any type of elective procedure, the physician must have adequate specialized training before undertaking the responsibility of performing the procedure.
  • The physician must always comply with all applicable laws and regulations as well as the ethical requirements and the professional standards established by the National Medical Association and other appropriate medical organizations in the community. The patients are entitled to the same confidentiality and privacy as is required with any medical treatment.

When IVF techniques produce excess ova which will not be utilized for the immediate treatment of sterility, their use must be determined in agreement with the donors; excess ova can be:

  • Destroyed
  • Cryopreserved
  • Fertilized and cryopreserved

(Adopted by the 39th World Medical Assembly Madrid, Spain, October 1987)

DMC order

Order DMC/DC/F.14/Comp.631/2010/ 12th April, 2010

The Delhi Medical Council examined a complaint of P K alleging professional misconduct/medical negligence on the part of JMH in the treatment administered to the complainant. The Council observes that the patient reported to JAH on 30th October, 2009 with complaint of Lt. Abdominal pain radiating to back, sweating and was found to have tachycardia and increased systolic blood pressure reading. In addition to differential diagnosis of renal colic, pain of cardiac origin was suspected. Patient was given ICU care and ECG and cardiac enzymes were investigated. Trop–T test was done to exclude cardiac (coronary) disease. As patient stayed in the hospital only for four hours and left against medical advise (LAMA), there is no question of medical negligence, otherwise it is presumed that the patient would have been further investigated and managed. Pain of renal origin and pain of cardiac original were differential diagnosis and patient was not neglected and investigated reasonably. In light of the above, prima facie, no case of medical negligence or professional misconduct is made out against the doctors.

    Interesting Website to know

Dr Jitendra Ingole, MD Internal Medicine, Asst Professor (Medicine), SKN Medical College, Pune


A good website on finance, where many finance calculators are available to assess one’s future goals

    Lab Update

(Dr. Naveen Dang and Dr Arpan Gandhi)

International Normalized Ratio

The International Normalized Ratio (INR) is used to monitor the effectiveness of blood thinning drugs such as warfarin (Coumadin). These anti–coagulant drugs help inhibit the formation of blood clots. They are prescribed on a long–term basis to patients who have experienced recurrent inappropriate blood clotting.

    Medi Finance Update

Personal Accident Individual

Expenses on vitamins and tonics unless forming part of treatment for injury or disease as certified by the attending physician. Injury or disease directly or indirectly caused by or contributed to nuclear weapons/materials

    Drug Update

List of Drugs Prohibited for Manufacture and Sale through Gazette Notifications under Section 26a of Drugs & Cosmetics Act 1940 by the Ministry of Health and Family Welfare

List of drugs prohibited for import

Chloral Hydrate as a drug

    IMSA Update

International Medical Science Academy (IMSA) Update

Chronic hepatitis C infection in children

Accumulating evidence supports the use of combination therapy with pegylated interferon and ribavirin to treat chronic hepatitis C infection in children. In a multicenter trial, this combination yielded 93 percent sustained viral response in patients with genotype 2 or 3, and 53 percent in those with genotype 1.

(Ref: Wirth S, et al. High sustained virologic response rates in children with chronic hepatitis C receiving peginterferon alfa–2b plus ribavirin. J Hepatol 2010;52:501).

    IJCP Special

Dr Good Dr Bad

Situation: A patient with mild hearing impairment wanted to know if passive smoking was harmful.
Dr Bad: It’s not harmful.
Dr Good: Avoid it.
Lesson: Second–hand tobacco smoke exposure may boost risk of hearing loss. Passive exposure is linked to significantly elevated risk of hearing loss in the low-to-mid frequencies for never smokers and former smokers. (Fabry DA, et al. Secondhand smoke exposure and the risk of hearing loss. Tob Control. 2010 Nov 15)

Make Sure

Situation: A patient on 10 units of insulin developed hypoglycemia with 11 units of insulin
Reaction: Oh My God! Why was additional insulin given?
Lesson: Make sure that insulin dose is calculated correctly. The formula is 1500/total daily dose. The value will be the amount of sugar fluctuation with one unit of insulin.

    Lighter Side of Reading

An Inspirational Story

The Pilgrimage

Once there were two neighbors who were friends and, at the same time, were rivals. Both of them were very shrewd and miserly. At times they were absolutely, unthinkably undivine. One day they decided to go on a pilgrimage. Their wives made up delicious baskets of food for them and they left very early in the morning. After they had walked for two hours, it was breakfast time. One of them said, "Let us not stop for breakfast. We don’t need to eat right now."

The other one said, "I agree. Let’s keep walking and stop later for lunch instead." So they continued walking. When lunchtime came, one of them said, "I’m not hungry. If you want to eat, go ahead, but I’m not hungry in the least." The other one said, "I’m not hungry either. Let’s walk until we are tired. Then we can stop and eat."

Both of them were perfect rogues. Each one thought that his own wife had made the best food and didn’t want to share it with the other. Each one thought, "If we walk for some time, then my friend will become tired and fall asleep. Then I'll be able to eat my food all by myself. I don't want to share any of it with him." They walked until it was evening and they were both very tired. After they stopped, each one was waiting for the other to fall asleep. They waited and waited. Finally, both of them fell asleep. The following morning when they woke up, they saw that their food was crawling with ants. Instead of blaming themselves, they got mad at their wives! "We didn’t check the food when they gave it to us. Now we find ants all over it. When we go home, we’ll give them a piece of our mind," they agreed.

But they were still tired and decided to rest a while longer. When they woke up a few hours later, they found rats eating what was left of their food. They were so disgusted that they immediately went home and insulted and scolded their wives. Their wives said, "Why didn’t you eat the food we gave you during the day?" Each one told his wife, "I didn’t want to share any of your excellent food with that rascal. It took him so long to fall asleep that I fell asleep too."

Each wife told her husband, "Since both of you are so greedy and miserly, when you start on your pilgrimage again, I will give you simple food–a loaf of bread–which you can share with your friend. He will be pleased if you share it. Since you are traveling together, you can at least have this much friendship." One wife made bread that was very salty and the other made bread with no salt at all. Since their wives had told them that the food was very simple, both men were extremely generous. One of them said, "I am sure your wife is a good cook. Let’s exchange food." The other one said, "That is an excellent idea." So they exchanged their food and started eating. The one who got the salty bread said, "Your wife can’t cook!"

The other one responded with, "Your wife can’t cook! There’s no salt in this bread. It’s tasteless." The first man said, "My wife is an excellent cook." The other one said, "Your wife! Then how is it that she forgot to put salt in the bread?" The first one said, "How is it that your wife put too much salt in her bread?" They continued to fight until their pilgrimage came to an end, and again they went home and insulted their wives.

Each of them said to his wife, "You made horrible food. I was ashamed." Their wives said, "We thought that you were good friends. If you had shared your food with each other, there would have been no problem. One loaf of bread had too much salt and the other had no salt. If you had shared, it would have been delicious for both of you."

The husbands learned an important lesson from their wives: When you share with your friends, you will lead a more fulfilling life.


Mind Teaser

Read this…………………

thought an 

Yesterday’s eQuiz:
A 75 year old male is diagnosed with pulmonary embolism. His past medical history is significant for diabetes mellitus with retinopathy, hypertension and coronary artery disease. His admission labs show normal CBC, Sodium: 136, Potassium: 4.6, Glucose 200mg%, normal liver panel and creatinine of 300 micromoles/liter.

Which of he following drugs would require monitoring during therapy?

1. Unfractionated heparin
2. Enoxaparin
3. Coumadin (Warfarin)
4. Argatroban

Answer for eQuiz:
B. Enoxaparin, as it is renally cleared and will need monitoring in this patient with chronic kidney disease likely secondary to diabetes mellitus. If full dose enoxaparin is given without close monitoring in patients with kidney disease, the drug tends to accumulate leading to overdose and increased risk of bleeding. Argatroban is cleared by the liver and its dose may need adjustment in liver disease.

Correct answers received from: Dr Muthumperumal Thirumalpillai

Answer for 28th November Mind Teaser: "long overdue"
Correct answers received from: Dr Rashmi Chhibber, Dr Anupam, Dr Prachi, Dr.K.V.Sarma, 

Send your answer to ijcp12@gmail.com


Laugh a While
(Contributed by Dr GM Singh)

A little boy was sitting outside a store eating one snickers candy bar after another, when an older man walked up and said: "You shouldn’t be eating so much candy, it’ll rot your teeth, it’s just bad for you to eat so much candy."

The little boy looked up and said: "My grandfather lived to be 95 years old". The older man asked: "Oh? by eating snickers candy bars?" The little boy said: "No……by minding his own business."

    Readers Responses
  1. Thanks for posting emedinews daily, I enjoy going through it. I am a consultant pediatrician with 30 years standing and a DNB teacher and coordinator, I wish to get associated with eMedinewS, may be on a weekly or fortnightly basis. Thanks Dr Sanwar Agrawal, Ekta Institute of child health
    Public Forum

(Press Release for use by the newspapers)

The first Pyramid Meditation Centre to open in Delhi

The first ever meditation centre under a pyramid will open to public on 2nd December, 2010. Located at C–599, Defence Colony, the centre will be the first one in the city where 40–50 people can meditate at a time.

Addressing a press conference, Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India and Acharya Dr. Sadhvi Sadhna Ji Maharaj, a spiritual scholar said in a joint statement that any meditation done inside pyramid or underneath a pyramid is called Pyramid Meditation. By meditating under a pyramid, the whole body is revitalized, the mental and intellectual capacities are increased and energy cells get charged easily.

Meditation is nothing but a journey from sympathetic to parasympathetic mode of life which is away from stress/strains and feelings. Meditation done inside a pyramid is twice more powerful as the structure of the pyramid collects and radiates energy. So, when one meditates under a pyramid, energy power of the practitioner increases. Not only this, the same energy and freshness remain for a longer time. Pyramid energy is, therefore, useful in preserving milk and other perishable things. The taste of coffee, wine and juices is also improved. Under pyramid energy can be used to sharpen the used knife and can help in making the foul smell disappear. Wounds and boils also heal quickly under the pyramid energy.

Experiencing meditation under a pyramid gives an early feeling of calm, relaxation and inner happiness. One can easily shut themselves from external stimulants. For beginners, meditation in pyramid is much easier as it reduces the level of stress and tension in the body.

A pyramid is a sloped structure with four triangular sloping sides resting on a square position and the four apices joining at a point forming the apex of the pyramid. Each triangular slope is an isolate triangle with the two sloping sides. All the sides are equal and all are similar to each other with an equal area.

Apart from the inauguration of the pyramid, 2nd December function will also include 3rd Flag Changing ceremony of Ahimsa Paryvaran Sadhna Mandir. The function will be held at 9 am at the Pyramid premises.

    Forthcoming Events

Hospital Infrastructure 2010

Date: December 7–9, 2010, Venue: Bombay Exhibition Center, Mumbai
Website: www.hospitalinfra–india.com

eMedinewS Events: Register at emedinews@gmail.com

eMedinewS Revisiting 2010

The 2nd eMedinewS – revisiting 2010 conference will be held at Maulana Azad Medical College, New Delhi on January 08–09, 2011.

January 08, 2011, Saturday, 6 PM – 9 PM – Opening Ceremony, Cultural Hungama and eMedinewS Doctor of the Year Awards. For registration contact – emedinews@gmail.com

January 09, 2011, Sunday, 8 AM – 6 PM – 2nd eMedinewS revisiting 2010, A Medical Update

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