ASICON
ASICON
org
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He i
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m Prev o r F
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Scaling
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Patrons Dr. V. M. Katoch, ICMR Dr. Amy DuBois, US Embassy President Dr. I. S. Gilada, Mumbai
Dr. R. R. Gangakhedkar, Pune
Dr. Amar Pazare, Mumbai Dr. Rajiv Soman, Mumbai Dr. Jyoti Dhar, UK
Co-Chairs Scientific Committee Dr. Dilip Mathai, Hyderabad Dr. R. Sajithkumar, Kottayam Programme Directors
Dr.Rajiv Jerajani, Mumbai Dr. Preeti Mehta, Mumbai
Dr. Milind Bhrushundi, Nagpur Dr. Trupti Gilada Baheti, Boston Dr. Glory Alexander, Bangalore Dr. S. K. Guha, Kolkata
Organizing Secretaries Dr. George Oomen, Mumbai Joint Organizing Secretaries Dr. Mamatha Lala, Mumbai Regional Coordinators Dr. Geeta Bansal, Kota Dr. G. Manoharan, Coimbatore Dr. Alok Vashishtha, Haridwar Members
Dr. Murugesh Pastapur, Gulbarga Dr. Nikhil Sarangdhar, Mumbai Dr. Naval Chandra, Hyderabad Dr. Harsh Toshniwal, Ahmedabad
Dr. Mukesh Agrawal, Mumbai Dr. Dipanjan Bandyopadhyay, Kolkata Dr. Salil Bendre, Mumbai Dr. Prakash Bora, Mumbai Dr. Vanita Gupta, Chandigarh Dr. S. N. Mothi, Mysore Dr. G. D. Ravindran, Bangalore Dr. P. S. Shankar, Gulbarga Dr. Sarman Singh, Delhi
Dr. Arun Bamne, Mumbai Dr. Ruby Bansal, Ghaziabad Dr. P. C. Bhattacharya, Guwahati Dr. Tapan Dhole, Lucknow Dr. Ragini Mehrotra, Allahabad Dr. Geeta Niyogi, Mumbai Dr. Ira Shah, Mumbai Dr. Narendra Singh, Imphal Dr. Agam Vora, Mumbai
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Vice Presidents
Dr. T. N. Dhole, Lucknow Dr. Dilip Mathai, Vellore
Secretary General
Dr. Murugesh Pastapur, Gulbarga
Treasurer
Dr. K. C. Mohanty, Mumbai
Members
Dr. Glory Alexander, Bangalore Dr. Milind Bhrushundi, Nagpur Dr. Prakash Bora, Mumbai Dr. Naval Chandra, Hyderabad Dr. S. K. Guha, Kolkata Dr. Preeti Mehta, Mumbai Dr. S. N. Mothi, Mysore Dr. George Oommen, Mumbai Dr. Narendra Potsangbam, Imphal Dr. G. Ravindran, Bangalore Dr. Rajiv Jerajani, Mumbai Dr. R. Sajithkumar, Kottayam Dr. Dipanjan Bandyopadhyay, Kolkata (ad-hoc) Dr. Ruby Bansal, Ghaziabad (ad-hoc) Dr. Alok Vashishtha, Haridwar (ad-hoc)
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NATIONAL
Dr. Glory Alexandar, Bangalore Dr. Mukesh Agrawal, Mumbai Dr. Milind Bhrushundi, Nagpur Dr. Arun Bamne, Mumbai Dr. Dipanjan Bandyopadhyay, Kolkata Dr. Ruby Bansal, Ghaziabad Dr. Prakash Bora, Mumbai Dr. Naval Chandra, Hyderabad Dr. Tapan Dhole, Lucknow Dr. R. R. Gangakhedkar, Pune Dr. I. S. Gilada, Mumbai Dr. S. K. Guha, Kolkata Dr. Rajiv Jerajani, Mumbai Dr. Shashank Joshi, Mumbai Dr. V. M. Katoch, ICMR, Delhi Dr. Sunil Khaparde, NACO Dr. N. Kumaraswamy, Chennai Dr. G. Manoharan, Chennai Dr. Dilip Mathai, Vellore Dr. Preeti Mehta, Mumbai Dr. Rajeev Mehta, Mumbai Dr. K. C. Mohanty, Mumbai Dr. S. N. Mothi, Mysore Dr. A. Muruganathan, Coimbatore Dr. George Oomen, Mumbai Dr. Atul Patel, Ahmedabad Dr. Amar Pazare, Mumbai Dr. Sanjay Pujari, Pune Dr. G. D. Ravindran, Banglore Dr. B. B. Rewari, NACO Dr. Sajithkumar, Kottayam Dr. Ira Shah, Mumbai Dr. Sarman Singh, Delhi Dr. Rajeev Soman, Mumbai Dr. Harsh Toshniwal, Ahmedabad Dr. Alok Vashishtha, Haridwar
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03
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08:30 am - 09:30 am 09:30 am - 10:30 am 10:30 am - 10:45 am 10:45 am - 01:15 pm 01:15 pm - 02:00 pm 02:00 pm - 03:15 pm 03:15 pm - 04:30 pm 04:30 pm - 05:00 pm
Free Papers 3 Scientific Session - 9 Tea Break Scientific Session - 10 Lunch Scientific Session - 11 Scientific Session - 12 Valedictory Function
Scientific Sessions
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Scientific program is aimed at aspects related to clinical management of HIV infection and coinfections besides pre and post exposure prophylaxis. It shall comprise of Plenary, guest lectures, invited presentations, debate sessions, symposia, free papers and case presentations.
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Delhi, 2005
Jaipur, 2009
Hyderabad, 2010
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Lucknow, 2011
Bangalore, 2012
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ABSTRACT FORM
Prof / Dr / Mr / Ms Author(s): Affiliation:
4rd
Last date of submission: 10th October, 2013 Please mention one category only of your choice Epidemiology Diagnosis Anti Retroviral Therapy Research and Future Remedies Opportunistic Infections Others
Presenting Author Prof / Dr / Mr / Ms ................................................................................................................................... Mailing Address ................................................................................................................................................................... ...............................................................................City ..........................................................Pin........................................... Tel No. ...................................................................Cell No....................................................Fax.......................................... Email........................................................................................................................................................................................ Applied for Scholarship : Yes / No .........................................................................................................................................
UNDERTAKING
I have read the instructions and agree to abide by the decision of the Scientific Committee I also stipulate that the material PAGE presented is my original work and I have obtained permission of my co-authors to present the same.
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Date & Place: Presenting Author's Name & Signature
4. 5.
6. 7.
8.
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9. 10.
Note:
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REGISTRATION FORM
(in block letters starting with family name) Prof / Dr / Mr / Ms ............................................................................................................................................... Mailing Address ..................................................................... ............................................................................................................................................................................. ................................ .................................... City ................................................................................... Pin ....... Tel. No................................................. Cell No ............................................... Fax ........................................... E-mail ................................................................................................................................................................. *Accompanying Persons Name ......................................................................................................................
*Limited occupancy (Charged at same rates and entitled to all the events except scientific sessions and conference kit)
4rd
S.No.
1. 2. 3.
Occupancy
Single Twin Sharing Triple Sharing**
The package is inclusive of 3 nights (nights of 12-13-14 Dec. or 13-14-15 Dec.) accommodation with breakfast, conference, registration, airport transfers, internet, three lunches and one dinner. Check-out strictly at noon.
Registration - Non-Residential
S.No.
1. 2. 3.
$ 350/-
Registration includes entry to scientific sessions on all three days, conference kit, conference proceedings including DVD, three lunches and one dinner.
#Letter from Head of the Dept. /Institute is compulsory. ASI Life Members are entitled to Rs. 1000/- rebate in Delegate Fee or any Package.
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For international delegates, packages will be (-) Rs.6,500/- and (+) Reg. fees in US $ Check in on 12th Dec. & Check out on 15th Dec. before noon (or 13th Dec. & 16th Dec. respectively) Accompanying Person fees are same as of Delegate
Mode of Payment (Online www.asi-asicon.org /Cheque/Pay order/Cash in favour of AIDS Society of India payable at Mumbai. For outstation non-at-par cheques add Rs 100/-) Cheque/Draft No.:...........................Date:....... Amount(Rs:............................../.. Bank........................................Branch:........ .................................Dated:............................Signature:............................... .
In e-mail correspondence, pl. mention 'Registration' or 'Residential Package' in the subject line Please send your completed form along with payment to Conference Secretariat:
Dr. Ishwar Gilada, President, ASI & ASICON 2013, Secretariat: Unison Medicare & Research Centre, Maharukh Mansion, Alibhai Premji Marg, Grant Road (E), Mumbai 400007 Tel. (22) 23061616; Fax: 23000016; E-mail: [email protected]; [email protected] Websites: www.asi-asicon.com & www.asi-asicon.org
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4rd
Registration
I undertake that I have not received financial support from other resources / have received partial support from other resources (quantify/details). Place:...................................................Date:............................Applicant's Signature: ............................... Signature Recommended by: Name & Designation: Stamp
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Academic Partners
API
ICMR
MCI
Conference Secretariat
Dr. Ishwar Gilada, President, ASI & ASICON 2013, Secretariat: Unison Medicare & Research Centre, Maharukh Mansion, Alibhai Premji Marg, Grant Road (E), Mumbai 400007 Tel. (22) 23061616; Fax: 23000016; E-mail: [email protected]; [email protected] Websites: www.asi-asicon.com & www.asi-asicon.org
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