Document:

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                                                                    EXHIBIT 10.4

                AMENDMENT NO. 1 TO SECURITIES PURCHASE AGREEMENT

     THIS Amendment No. 1 (this "Amendment"), dated July 25, 2002 to the
SECURITIES PURCHASE AGREEMENT (the "Agreement"), dated December 17, 1999, is
entered into by and among Allied Healthcare Group Limited, formerly known as
Transworld Holdings (UK) Limited, a company incorporated in England and Wales
with registered number 3890177 ("UK Parent"), Transworld Healthcare (UK)
Limited, a company incorporated in England and Wales with registered number
3370146 and a wholly-owned subsidiary of UK Parent ("TW UK"), each of the
Purchasers and Allied Healthcare International Inc. (f/k/a Transworld
Healthcare, Inc.), a New York corporation and sole shareholder of UK Parent
("Transworld"). Transworld, UK Parent and TW UK are hereinafter referred to
collectively as the "Corporate Group." All capitalized terms which are used but
otherwise defined herein shall have meanings specified in the Agreement.

                               W I T N E S S E T H
                               - - - - - - - - - -

     WHEREAS, on December 17, 1999, the parties hereto entered into the
Agreement, pursuant to which (i) UK Parent issued and the Purchasers subscribed
for the Subordinated Notes; (ii) TW UK issued and the Purchasers subscribed for
the Warrants; (iii) TW UK issued and UK Parent subscribed for the Mirror Notes;
and (iv) TW UK issued and the Purchasers' Representative subscribed for a
Special Share of TW UK;

     WHEREAS, as of the date hereof, Transworld has approved the reorganization
of the Corporate Group, pursuant to which TW UK shall become a wholly-owned
subsidiary of UK Parent, which is and shall remain a wholly-owned subsidiary of
Transworld (the "Reorganization") in accordance with that certain Master
Reorganization Agreement, dated as of April 24, 2002 by and among the Corporate
Group and the Investors named therein (as subsequently amended, the "Master
Reorganization Agreement");

     WHEREAS, in connection with the Reorganization, the Warrants issued to the
Purchasers pursuant to the Agreement shall be cancelled and the Mirror Note
between UK Parent and TW UK is to be amended and restated;

     WHEREAS, in connection with the Reorganization, the Purchasers will be
entitled, subject to the terms and conditions of the Master Reorganization
Agreement, to the right to receive shares of TWUS Common Stock and TWUS
Preferred Stock, and UK Parent will issue shares of the Mirror Preferred Stock
to Transworld; and

     WHEREAS, in connection with the Reorganization and cancellation of the
Warrants the parties hereto desire to amend the Agreement to make appropriate
changes thereto to retain certain of the rights, covenants and agreements
originally provided thereon as to be applicable in light of the Reorganization.

     NOW, THEREFORE, each of Transworld, UK Parent and TW UK, in consideration
of the mutual covenants and agreements set forth herein and for other good and
valuable

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consideration, the receipt and sufficiency of which are hereby acknowledged,
agrees with the Purchasers as follows and vice versa:

     1. Amendment to Mirror Notes. Effective hereby, upon the terms and subject
to the conditions herein, the existing Mirror Notes shall be canceled and the
Amended and Restated Mirror Notes, substantially in the form attached hereto as
Exhibit A shall automatically be substituted therewith.

     2. Amendment to Section 1.1. Effective hereby, the following definitions
shall be substituted in their entirety for the same definition in Section 1.1 of
the Agreement:

     "Affiliate" means, with respect to any specified Person, any other Person
directly or indirectly controlling (including, but not limited to, each director
and executive officer of such Person), controlled by or under direct or indirect
common control with such specified Person. A Person shall be deemed to control a
company if such Person possesses, directly or indirectly, the power to direct or
cause the direction of the management and policies of such company whether
through the ownership of voting securities, by contract or otherwise.
Notwithstanding the foregoing, in no event shall the initial Purchasers be
considered Affiliates of the Companies (including of Transworld) for purposes of
this Agreement.

     "Companies" means collectively, UK Parent and TW UK considered as a single
enterprise, until a successor replaces UK Parent or TW UK and thereafter
includes the successor or successors, as the case may be provided that, with
respect to Articles XVI and XVIII and Section 14 of this Amendment, "Companies"
shall also include Transworld along with UK Parent and TW UK.

     "Covenant Breach" has the meaning ascribed thereto in Section 17 of the
Certificate of Designations.

     "Credit Facility" means the credit agreement dated as of the date of this
Agreement among the Group Companies named therein, the Banks and the other
lenders, if any, parties thereto from time to time, as amended, restated,
supplemented, waived, replaced (whether or not upon termination, and whether
with the original lenders or otherwise), refinanced, restructured, or otherwise
modified from time to time.

     "Designated Indebtedness" means: (a) Bank Indebtedness, (b) Mezzanine
Indebtedness or (c) Refinancing Indebtedness with respect thereto.

     "Group Companies" means UK Parent, TW UK and their respective Subsidiaries;
provided, that with respect to Articles XVI and XVIII, "Group Companies" shall
also include Transworld and its respective Subsidiaries.

     "Legal Holiday" means a Saturday, Sunday or a day on which banking
institutions in London, England, or New York, New York are not required to be
open.

     "Liquidity Event" means (i) a sale, assignment, transfer, lease, conveyance
or other disposal of 90% or more of the Capital Shares of any of Transworld, UK
Parent or TW UK to a Person who is not an Institutional Investor or an Affiliate
of an Institutional Investor, including

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by way of scheme of arrangement or other business combination (whether or not
Transworld, UK Parent or TW UK is the Surviving Person), whether in one
transaction or a series of related transactions, (ii) a sale, assignment,
transfer, lease, conveyance or disposal of Property or assets of the Group
Companies representing in the aggregate 90% or more of the total value of all
Group Assets or generating in the aggregate 90% or more of all Group Revenues,
whether voluntary or involuntary, in one transaction or a series of related
transactions, or (iii) an Insolvency Event with respect to Transworld, UK Parent
or TW UK, other than by reason of action taken by or on behalf of the Series A
Director(s) or the Purchasers as a group.

     "Majority in Interest of the Purchasers" or "Majority in Interest" means
the holders of greater than 50% of the sum of (i) all shares of Common Stock
issuable upon conversion of all shares of Series A Preferred Stock that remain
outstanding as of the time of determination and (ii) shares of Common Stock
issued upon conversion of the shares of Series A Preferred Stock; provided,
however, that with respect to clause (ii) only those shares of Common Stock
beneficially owned by the Person who converted the corresponding Series A
Preferred stock (or their Affiliates) shall be included in the calculation of a
Majority in Interest.

     "Mirror Notes" has the meaning ascribed thereto in the recitals hereof; and
shall also refer to the refinanced Mirror Notes issued pursuant to Section 1 of
the Amendment No. 1 to the Agreement.

     "Purchasers" has the meaning ascribed thereto in the introduction hereof,
provided, however, that with respect to any Securities that are Shares of Series
A Preferred Stock, the Purchasers shall include any "holders" thereof, as such
term is defined in the Certificate of Designations.

     "Qualified Average Price" means the Closing Price per Share of Common Stock
as reported by the principal securities exchange on which the Shares of Common
Stock are listed for trading, so long as such exchange is the New York Stock
Exchange, the NASDAQ National Market, the American Stock Exchange or a
Designated Offshore Securities Market, for 30 consecutive Trading Days, provided
that (i) on each one of such Trading Days the Closing Price is equal to or
higher than the minimum price required to achieve a Qualified Public Value if
such price alone was deemed to equal the Qualified Average Price and (ii)
throughout such 30-day period at least 20% of the Ordinary Shares outstanding
are held by Persons who are not Affiliates of Transworld, any Group Company or
any Purchaser and are freely transferable in the public trading market.

     "Qualified Public Value" means a Qualified Average Price such that the
product of such Qualified Average Price times the aggregate number of shares of
Common Stock issued pursuant to or issuable upon conversion of the shares of
Series A Preferred Stock is equal to or greater than 2.5 times the Total
Investment.

     "Redemption Security" has the meaning ascribed thereto in Section 6.3
hereof.

     "Securities" mean, collectively, the Subordinated Notes, the PIK Notes, the
Warrants, the Ordinary Shares issuable upon exercise of the Warrants, the Mirror
Notes, the Mirror PIK Notes, the shares of Series A Preferred Stock and the
shares of the Mirror Preferred Stock.

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     "Transaction Documents" means, collectively, this Agreement (including the
Amendment), the Subordinated Notes, the PIK Notes, the Warrant Instrument, the
Warrants, the Mirror Notes, the Mirror PIK Notes, the Registration Rights
Agreement, the Voting Trust Agreement, the Intercreditor Agreement, the
Transworld Rights Letter, the Purchaser's Rights Letter, the Joinder Agreement,
the Expenses Sharing Letter Agreement, the Certificate of Designations, the
Charter Documents of Transworld, UK Parent and TW UK, the Master Reorganization
Agreement and any and all agreements, certificates, instruments and other
documents contemplated hereby or thereby or executed and delivered in connection
herewith or therewith.

     "Voting Trust Agreement" means the Voting Trust Agreement, dated as of the
date hereof, by and among TW UK, UK Parent, Transworld, the Purchasers'
Representative and the Trustee, as such is amended from time to time.

     3. Amendment to Section 1.1. Effective hereby, the following definitions
shall be added to the defined terms included in Section 1.1 of the Agreement:

     "Certificate of Designations" means Article FIFTH of the Certificate of
Amendment to the Certificate of Incorporation of Allied Healthcare International
Inc. dated June 26, 2002.

     "Closing Date" shall have the meaning ascribed to such term in the Master
Reorganization Agreement.

     "Common Stock" means the common stock, par value $.01 per share, of
Transworld.

     "holders" shall mean the holders of the Series A Preferred Stock, unless
such other meaning is clearly ascribed.

     "Holders Redemption" shall have the meaning set forth in Section 8.1 of
this Agreement.

     "Holders' Redemption Offer" shall have the meaning set forth in Section 8.2
of this Agreement.

     "Holders' Redemption Purchase Date" shall have the meaning set forth in
Section 8.2 of this Agreement.

     "Institutional Investors" means Triumph Partners III, L.P., Triumph III
Investors, L.P., and Paribas.

     "Insolvency Breach" has the meaning ascribed thereto in Section 17(b) of
the Certificate of Designations.

     "Lead Investor" means Triumph Partners III, L.P.

     "Master Reorganization Agreement" has the meaning set forth in Section 12
of the Certificate of Designations.

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     "Mirror Note Redemption Price" has the meaning set forth in Section 12 of
the Certificate of Designations.

     "Mirror PIK Note Redemption Price" has the meaning set forth in Section 12
of the Certificate of Designations.

     "Mirror Preferred Stock" has the meaning set forth in Section 12 of the
Certificate of Designations.

     "Mirror Preferred Stock Preference Amount" has the meaning set forth in
Section 12 of the Certificate of Designations.

     "Mirror Preferred Stock Purchase Price" has the meaning set forth in
Section 12 of the Certificate of Designations.

     "Series A Preferred Stock" has the meaning set forth in Section 12 of the
Certificate of Designations.

     "Series A Director" has the meaning set forth in Section 3(a) of the
Certificate of Designations.

     "Series A Preference amount" has the meaning set forth in Section 4(a) of
the Certificate Designations.

     "Series A Purchase Price" shall have the meaning set forth in Section 8(a)
of the Certificate of Designations.

     4. Amendment to Section 4.22(c). Effective hereby, the following paragraph
shall be substituted in its entirety for Sections 4.22(c) of the Agreement:

         (c) TW UK shall be under no liability with respect to any claim under
this Article IV unless and until the aggregate amount of all claims against TW
UK exceed (pound)250,000, but if liability exceeds that figure then all claims,
including claims previously notified, shall accrue against TW UK. The aggregate
liability of TW UK with respect to all claims under this Article IV shall not
exceed (pound)22.0 million, plus all outstanding and accrued interest on the
Subordinated Notes and the PIK Notes and accrued dividends (whether or not
declared or paid) on the shares of Series A Preferred Stock.

     5. Amendment to Article VI. Effective hereby, the following shall be
substituted in its entirety for Article VI of the Agreement: Intentionally
Omitted.

     6. Amendment to Article VII. Effective hereby, the following shall be
substituted in its entirety for Article VII of the Agreement: Intentionally
Omitted

     7. Amendment to Article VIII. Effective hereby, the following shall be
substituted in its entirety for Article VIII of the Agreement:

                                  ARTICLE VIII

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               REDEMPTION OF TRANSWORLD SERIES A PREFERRED STOCK

         8.1 Redemption of Transworld Series A Preferred Stock. The Series A
     Preferred Stock, subject to the terms of the Intercreditor Agreement, shall
     be subject to purchase and Redemption by Transworld, in whole or in part,
     at the Series A Purchase Price, at the option of a Majority in Interest of
     the Purchasers ("Holders' Redemption") upon and after the occurrence of a
     Redemption Event; provided, however, that the Holders' Redemption cannot be
     exercised on more than three (3) separate occasions or for an aggregate
     Series A Purchase Price equal to less than (i) (pound)5.0 million on any
     occasion or (ii) 100% of the remaining shares of Series A Preferred Stock
     outstanding at the time if exercise of the Holders' Redemption would result
     in less than (pound)5.0 million of Original Issue Price being owed with
     respect to all remaining outstanding shares of Series A Preferred Stock in
     the aggregate. In such event UK Parent shall be required to redeem, subject
     to the limitations of Section 8.5, the shares of the Mirror Preferred Stock
     in the manner provided in Section 8.3 hereof and TW UK shall be required to
     redeem, subject to the limitations of Section 8.5, the Mirror Notes and
     Mirror PIK Notes in the manner provided in Section 8.3 hereof. The date on
     which such Redemption Event occurs is referred to as the "Redemption Event
     Trigger Date." A "Redemption Event" shall mean, with respect to the shares
     of Series A Preferred Stock elected to be purchased by the Purchasers, (i)
     any Liquidity Event, or (ii) a date subsequent to the December 17, 2007 if
     the Bank Indebtedness and the Mezzanine Indebtedness have been paid in full
     on or before such date. The "Series A Purchase Price" shall be equal to the
     Series A Preference Amount.

         8.2 Holders' Redemption Offer Procedures. Within five (5) Business Days
     after Transworld becomes aware of the occurrence of a Redemption Event and
     in any event not later than the Redemption Event Trigger Date, Transworld
     shall mail a notice (the "Holders' Redemption Offer") to each of the
     Purchasers notifying them that the shares of Series A Preferred Stock will
     be purchased and redeemed, respectively, at the election of the Purchasers
     in accordance with this Article VIII. If a Majority in Interest of the
     Purchasers elect to exercise their redemption rights pursuant to this
     Article VIII, they shall give notice to Transworld setting forth the number
     of shares of Series A Preferred Stock to be redeemed and the purchase date
     shall be the earlier of (i) a date selected by Transworld, but not later
     than 30 days from the date such notice is given, or (ii) if such notice
     relates to a Liquidity Event and is given prior to the occurrence of the
     Liquidity Event, the date of completion of the Liquidity Event (the
     "Holders' Redemption Purchase Date"). An election to exercise purchase and
     redemption rights pursuant to this Article VIII in connection with a
     Liquidity Event shall in all circumstances be conditional upon the
     completion of the Liquidity Event and no obligation to purchase or redeem,
     as the case may be, shares of Series A Preferred Stock shall arise if the
     Liquidity Event is not completed. In the event a Holders' Redemption is
     exercised with respect to a Liquidity Event, the Purchasers will be
     entitled to withdraw their election to tender the shares of Series A
     Preferred Stock by delivering to Transworld, for receipt not later than the
     close

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     of business on the second Business Day preceding the Holders' Redemption
     Purchase Date, facsimile transmission or letter to that effect. Upon a
     Purchaser's election to tender any shares of Series A Preferred Stock, the
     Purchaser will be required to surrender such shares of Series A Preferred
     Stock to Transworld at the address specified in the signature page hereto
     prior to the close of business on the Business Day preceding the Holders'
     Redemption Purchase Date. On the Holders' Redemption Purchase Date,
     Transworld will purchase the shares of Series A Preferred Stock tendered
     pursuant to Section 8.1 hereof for cash in an amount equal to the aggregate
     Series A Purchase Price for all shares of Series A Preferred Stock tendered
     for purchase. If not all of the shares of Series A Preferred Stock tendered
     pursuant to a Holders' Redemption Offer can be purchased or redeemed,
     respectively, by Transworld for any reason, Transworld shall select, on or
     prior to the Holders' Redemption Purchase Date, the shares of Series A
     Preferred Stock (or portions thereof) shares of Series A Preferred Stock to
     be purchased and redeemed, as the case may be, pro rata among the
     Purchasers and dividends shall continue to accrue on all shares of Series A
     Preferred Stock not redeemed, provided, however, that nothing in this
     Article VIII shall be deemed a waiver or contractual impairment of the
     right of the Purchasers to have all shares of Series A Preferred Stock
     purchased and redeemed in full pursuant to Section 8.1 hereof and
     Transworld shall not be relieved of its obligations to redeem unredeemed
     shares of Series A Preferred Stock in full. Promptly after the Holders'
     Redemption Purchase Date, Transworld shall, with respect to any shares of
     Series A Preferred Stock not purchased or redeemed, respectively, in whole,
     return to the appropriate Purchaser, the unredeemed shares of Series A
     Preferred Stock or a new stock certificate, as the case may be, equal in
     number to the unredeemed portion of the tendered shares of Series A
     Preferred Stock.

         8.3 Mandatory Redemption of Mirror Preferred Stock and Mirror Notes.
     Upon written notice to each of UK Parent and TW UK of Transworld's
     intention to purchase and redeem the shares of Series A Preferred Stock
     pursuant to Sections 8.1 and 8.2 above (which notice Transworld will be
     required to serve as soon as reasonably practicable after notice of
     election is given to Transworld pursuant to Section 8.2), and subject to
     the limitations of Section 8.5, UK Parent shall, immediately prior to such
     purchase and redemption by Transworld, redeem and purchase the Mirror
     Preferred Stock (in accordance with the terms and provisions of the Charter
     Documents of UK Parent). Concurrently, and subject to the limitations of
     Section 8.5, TW UK shall, immediately prior to such purchase and redemption
     of the Mirror Preferred Stock by UK Parent, redeem the Mirror Notes and the
     Mirror PIK Notes. Transworld shall use the funds it receives from such
     redemption of the Mirror Preferred Stock to purchase and redeem the shares
     of Series A Preferred Stock tendered by the Purchasers and accepted for
     redemption by Transworld pursuant to Section 8.2 hereof. UK Parent shall
     use the funds it receives from such redemption of the Mirror Notes to
     purchase and redeem the Mirror Preferred Stock tendered by Transworld
     pursuant to this Section 8.3 and the Charter Documents of UK Parent.

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         8.4 Obligations of UK and TW UK Upon Holders' Redemption. Prior to the
     Holder's Redemption Purchase Date, in connection with a Liquidity Event, UK
     Parent will, and UK Parent shall cause TW UK, in good faith to seek, to
     obtain any required consent of the holders of the Bank Indebtedness and/or
     the Mezzanine Indebtedness the terms of which prohibit Transworld from
     purchasing the Series A Preferred Stock or UK Parent from purchasing the
     Mirror Preferred Stock and/or TW UK from redeeming the Mirror Notes and the
     Mirror PIK Notes, as the case may be, so as to permit the making of the
     Holders' Redemption Offer and the purchasing of the shares of Series A
     Preferred Stock pursuant to Section 8.1, respectively, including repayment
     out of the proceeds of such Liquidity Event of all Obligations under such
     Bank Indebtedness and/or Mezzanine Indebtedness to the extent necessary to
     permit the making of the Holders' Redemption Offer and the purchase of
     shares of Series A Preferred Stock and accompanying purchase of the Mirror
     Preferred Stock, Mirror Notes and Mirror PIK Notes pursuant to Section 8.3
     hereof.

         8.5 Holders' Redemption Prohibited. Subject to compliance with Section
     8.4 hereof, if, at a Holders' Redemption Purchase Date, Transworld is
     prohibited or prevented under Applicable Laws (including lack of surplus
     under the laws of the State of New York) or under any other contractual or
     other arrangement, including, or other legal restriction whatsoever,
     directly or indirectly (which shall be deemed to encompass a similar
     prohibition or prevention with respect to UK Parent's or TW UK's or other
     Transworld Subsidiary's compliance with the provisions of Section 8.3) from
     purchasing all shares of Series A Preferred Stock for which purchase is
     elected hereunder pursuant to the Holders' Redemption, then Transworld
     shall purchase such shares of Series A Preferred Stock, to the extent
     permissible and shall purchase the remaining shares of Series A Preferred
     Stock, as soon as Transworld is not so prohibited. Transworld shall use all
     reasonable endeavors to take such action as shall be necessary or
     appropriate to review and promptly remove any impediment to its ability to
     purchase the shares of Series A Preferred Stock under the circumstances
     contemplated by Section 8.1 hereof (including to cause UK Parent and/or TW
     UK to take substantially similar actions), other than the Credit Agreements
     and the Intercreditor Agreement; provided, however, that this provision
     shall not require the repayment of Designated Indebtedness other then upon
     the occurrence of a Liquidity Event. In the event that Transworld fails for
     any reason to purchase any shares of Series A Preferred Stock for which
     purchase is required pursuant to Section 8.1 hereof , then (i) the
     Purchasers shall have the right to revoke their exercises of the Holders'
     Redemption at any time and (ii) if the Purchasers do not elect to so revoke
     such exercise, during the period from the applicable Holders' Redemption
     Purchase Date through to the date on which such shares of Series A
     Preferred Stock are purchased and redeemed, Transworld shall pay, in
     addition to such amounts due pursuant to exercise of the Holders'
     Redemption, to the Purchasers an amount equal to two percent (2%) per annum
     of the Series A Purchase Price for any of the shares of Series A Preferred
     Stock not purchased hereunder and the shares of Series A Preferred Stock
     which remain outstanding

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     shall continue to accrue dividends at the rate stated in Section 2 of the
     Certificate of Designations, plus two percent (2%) per annum. Nothing in
     this Section 8.5 shall impair or be deemed to limit, modify or affect the
     rights of the Purchasers (unless otherwise restricted, including, without
     limitation, under the Intercreditor Agreement) to pursue any available
     remedy, at law or in equity, to enforce or seek to enforce, in any manner
     whatsoever, Transworld's obligations under this Article VIII, including
     without limitation filing any suit or complaint or seeking to file a suit
     or complaint with any court of competent jurisdiction to obtain injunctive
     or other equitable relief and/or damages arising from a breach of
     Transworld's obligation to purchase the shares of Series A Preferred Stock
     and enforcing any judgment obtained in any such suit in any manner
     available under Applicable Law to judgment creditors in general.

         8.6 Failure of Transworld, UK Parent and TW UK to Honor Holders'
     Redemption. In the event that either Transworld or UK Parent fails to
     perform in full its obligations following the Purchasers' election to
     exercise the Holders' Redemption pursuant to Section 8.1 hereof, and TW UK
     fails to perform its obligations as a guarantor of the obligations of
     Transworld and UK Parent pursuant to Section 8.7 hereof, then a Majority in
     Interest of the Purchasers shall have the right to exercise the Holders'
     Redemption against TW UK to the same extent and with the same effect as
     such exercise against Transworld, and TW UK hereby agrees that it shall be
     fully bound by this Article VIII as if it were Transworld, except that (A)
     to the extent that any deductions and withholdings on account of Taxes are
     required under Applicable Law, or of any Taxes imposed on any Purchaser as
     a result of failure of Transworld to fulfill its obligations under Section
     8.1 hereof, and TW UK to fulfill its obligations under Section 8.7 below
     which would not have been required had no such failure occurred (unless
     such failure was directly attributable to a prohibition against such
     fulfillment by Transworld, UK Parent or TW UK, as the case may be, under
     Applicable Law), the Series A Purchase Price shall be increased, as may be
     necessary, so that after making all such deductions and withholdings and
     taking into account all such Taxes (whether applicable to the original
     redemption price payable or to additional sums payable under this Section
     8.6, and taking into account all Taxes on and arising by reason of the
     payment of additional sums payable under this Section 8.6), the Purchasers
     receive an amount equal to the sum that they would have received had no
     such deductions or withholdings been made or Taxes imposed, (B) the
     Companies shall make required deductions or withholdings, and (C) the
     Companies shall pay the full amount deducted or withheld to the relevant
     taxing or other Governmental Entity.

         8.7 TW UK Guaranty.

               (a) TW UK hereby unconditionally, irrevocably and absolutely
     guarantees payment in full of the obligations of Transworld and UK Parent
     to the Purchasers upon the election of the Purchasers to exercise the
     Holders' Redemption with respect to the shares of Series A Preferred Stock.
     To the extent that Transworld and/or UK Parent defaults on such
     obligations, TW UK shall be

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     absolutely and unconditionally obligated to pay the Series A Purchase
     Price, in immediately available funds in full on the Holders' Redemption
     Purchase Date, and shall not be entitled to set off any claim of any kind
     which Transworld, UK Parent or TW UK may have against anyone whether
     arising under or by reason of this Agreement, the other Transaction
     Documents or for any other reason of any kind. In the event that the
     Purchasers shall not for any reason receive on the Holders' Redemption
     Purchase Date the full payment of the Series A Purchase Price for the
     shares of Series A Preferred Stock being purchased and redeemed, then in
     any proceeding instituted by the Purchasers, no defense by TW UK to its
     obligation to pay the Series A Purchase Price, whether by counterclaim,
     affirmative defense or new matter, that is not also available to Transworld
     with respect to the primary obligation to purchase or redeem the shares of
     Series A Preferred Stock pursuant to the Holders' Redemption, shall be
     interposed or shall be of any force or effect, said defenses being waived
     for purposes of such proceeding.

               (b) Subject to compliance in full with this Article VIII by the
     Purchasers, TW UK waives any and all notice of the creation, renewal,
     extension or accrual of any component of the Series A Purchase Price and
     notice of or proof of reliance by the Purchasers upon this Section 8.7 or
     acceptance of this Section 8.7; the obligation to pay the Series A Purchase
     Price shall conclusively be deemed to have been created, contracted or
     incurred in reliance upon this Section 8.7; and all dealings between
     Transworld, UK Parent or TW UK, on the one hand, and the Purchasers, on the
     other, shall likewise be conclusively presumed to have been had or
     consummated in reliance upon this Section 8.7. TW UK waives diligence,
     presentment, protest, demand for payment and notice of default or
     nonpayment to or upon TW UK with respect to the Series A Purchase Price. TW
     UK's obligations under this Section 8.7 shall be construed as a continuing,
     absolute and unconditional guarantee of payment to pay the Series A
     Purchase Price and shall not be diminished or impaired by (i) any defense,
     set-off or counterclaim (other than a defense of payment) which may at any
     time be available to or be asserted by Transworld, UK Parent or TW UK
     against the Purchasers, or (ii) any other circumstance whatsoever (with or
     without notice to or knowledge of Transworld, UK Parent or TW UK) which
     constitutes, or might be construed to constitute, an equitable or legal
     discharge of Transworld from the obligation to pay the entire Series A
     Purchase Price, or of TW UK under this Section 8.7, upon the occurrence of
     any Insolvency Proceedings or in any other instance.

               (c) This Section 8.7 shall continue to be effective, or be
     reinstated, as the case may be, if at any time payment, or any part
     thereof, of any of the Series A Purchase Price is rescinded or must
     otherwise be restored or returned by the Purchasers upon the occurrence of
     any Insolvency Proceedings relating to Transworld or UK Parent or upon or
     as a result of the appointment of a receiver, intervener or conservator of,
     or trustee or similar officer for, Transworld or UK Parent or any
     substantial part of its property, or otherwise, all as though such payments
     had not been made.

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               (d) Any provision of this Section 8.7 which is prohibited or
     unenforceable in any jurisdiction shall, as to such jurisdiction, be
     ineffective to the extent of such prohibition or unenforceability without
     invalidating the remaining provisions hereof, and any such prohibition or
     unenforceability in any jurisdiction shall not invalidate or render
     unenforceable such provision in any other jurisdiction.

               (e) No failure to exercise, or any delay in exercising, on the
     part of the Purchasers, any right, power or privilege hereunder shall
     operate as a waiver thereof. No single or partial exercise of any right,
     power or privilege hereunder shall preclude any other or further exercise
     thereof or the exercise of any other right, power or privilege. A waiver by
     the Purchasers of any right or remedy hereunder on any one occasion shall
     not be construed as a bar to any right or remedy which the Purchaser would
     otherwise have on any future occasion. The rights and remedies provided in
     this Section 8.7 are cumulative, may be exercised singly or concurrently
     and are not exclusive of any rights or remedies provided by law.

         8.8 Further Action. Subject to the requirements of law, each of
     Transworld and UK Parent (or their successors or assigns or any Person to
     whom they transfer any of their shares in UK Parent or TW UK, respectively)
     shall exercise or direct the exercise of their voting rights (whether at a
     general or extraordinary meeting of shareholders or by consent in lieu of a
     meeting of shareholders) and where appropriate to give effect to such
     matters, shall convene any necessary shareholders meeting, for the purpose
     of passing (and, not revoking) such resolutions as may be required by law
     to approve or authorize any purchase of Securities pursuant to Article VIII
     hereof).

     8. Amendments to Articles IX, X, XI, XII, XIII, XIV and XV. Effective
hereby, the following shall be substituted in its entirety for Articles IX, X,
XI, XII, XIII, XIV and XV of the Agreement: Intentionally Omitted

     9. Amendment to Article XVI. Effective hereby, the following shall be
substituted in its entirety for Article XVI of this Agreement:

                                   ARTICLE XVI

                                   SUCCESSORS

         16.1 Merger or Consolidation.

               (a) The Companies shall not directly or indirectly, by operation
     of law or otherwise (i) be acquired by any other Person; (ii) permit
     substantially all of their assets to be acquired by any other Person
     (including an acquisition of stock of Subsidiaries which in the aggregate
     account for substantially all of Transworld's assets); (iii) consolidate,
     merge, or

                                       11
<PAGE>

     otherwise combine with or into any other Person; (iv) permit any other
     Person to acquire, consolidate, merge, or otherwise combine with or into
     the Companies; (v) permit any other Person to acquire, consolidate, merge,
     or otherwise combine with or into or be consolidated, merged, or otherwise
     combined with or into by, any Subsidiary (in a transaction in which such
     Subsidiary (or successor Person) remains (or becomes) a Subsidiary); or
     (vi) directly or indirectly, transfer, convey, sell, lease or otherwise
     dispose of all or substantially all of the properties and assets of any of
     the Subsidiaries as an entirety or permit any of the Subsidiaries to do any
     of the foregoing (except for the merger, consolidation or other combination
     of any Subsidiary of the Companies with or into, or the disposition of all
     or substantially all of the assets of any Subsidiary of the Companies to,
     the Companies or any Wholly-Owned Subsidiary of the Companies), unless:

               (i) in any such transaction in which the Person acquires by
         transfer, conveyance, consolidations, merger, combination, sale, lease
         or other disposition, as applicable, all or substantially all of the
         properties and assets of the Companies as an entirety (for purposes of
         this Article XVI, "Successor Companies"), such Successor Companies (i)
         shall be a corporation or limited liability company, (ii) shall be
         organized, duly incorporated and validly existing under the laws of the
         United States or England, (iii) shall expressly assume pursuant to the
         terms and conditions of this Agreement, in form reasonably satisfactory
         to a Majority in Interest of the Purchasers, the obligations with
         respect to the shares of Series A Preferred Stock then outstanding, and
         the performance of the covenants and obligations set forth in this
         Agreement and the Certificate of Designation on the part of the
         Companies to be performed or observed or shall agree to such
         alternative obligations, such that, following such assumption and
         agreement, the Purchasers will continue to have the right to achieve
         practical realization of the principal benefits intended to be provided
         to them hereby and thereby, which the Companies understand to include,
         without limitation, (A) the practical realization of the principal
         benefits intended to be provided under the Holders' Redemption as
         provided in Article 8, (B) the covenants as provided in Section 13 of
         the Certificate of Designations and (C) the enforcement against the
         Companies of any Covenant Breach or Insolvency Breach as provided in
         Section 17 of the Certificate of Designations, as nearly as may be, in
         relation to the circumstances of such Successor Companies, and (iv)
         shall take all such action and pass all such resolutions as may be
         necessary to enable it to assume and agree on all such obligations,
         including, without limitation, the obligations with respect to the
         guarantee of the Holders' Redemption and the purchase of shares of
         Series A Preferred Stock under Article VIII hereof;

               (ii) immediately before and after giving effect to such
         transaction, no Covenant Breach or Event of Default shall have occurred
         and be continuing;

                                       12
<PAGE>

               (iii) the Companies have delivered to the Purchasers an Officers'
         Certificate and a written opinion from legal counsel, each stating that
         such consolidation, merger, amalgamation, combination, conveyance,
         transfer, lease or acquisition and, if the assumption of the
         obligations of the Companies under this Agreement or the Certificate of
         Designations is required in connection with such transaction, such
         documents effecting such assumption, complies with this Article XVI and
         that all conditions precedent herein for relating to such transaction
         have been complied with and satisfied.

               (b) For purposes of the foregoing, the transfer (by lease,
     assignment, sale or otherwise), in a single transaction or series of
     transactions, of all or substantially all of the properties and assets of
     one or more Subsidiaries, the Capital Shares of which constitutes all or
     substantially all of the properties and assets of the Companies, shall be
     deemed to be the transfer of all or substantially all of the properties and
     assets of the Companies.

         16.2 Surviving Person Substituted. Upon any acquisition, disposal,
     consolidation, merger or other combination, or any transfer of assets in
     accordance with Section 16.1, the Surviving Person (if other than the
     Companies) following such transaction or formed by such consolidation or
     into which the Companies are merged or otherwise combined or to which such
     transfer is made shall succeed to, and be substituted for, and may exercise
     every right and power of, the Companies under this Agreement and the
     Certificate of Designations with the same effect as if such Surviving
     Person had been named as the Companies herein. When, and only when, a
     Successor Company assumes all of the obligations of the Companies hereunder
     and under the Securities and agrees to be bound hereby and thereby, the
     predecessor shall be released from such obligations.

     10. Amendment to Article XVII. Effective hereby, the following shall be
substituted in its entirety for Article XVII of the Agreement: Intentionally
Omitted.

     11. Amendment to Article XVIII. Effective hereby, the following shall be
substituted in its entirety for Article XVIII of the Agreement:

                                  ARTICLE XVIII

                                   AMENDMENTS

         18.1 Amendments and Supplements Requiring Consent of Purchasers; Other
     Consents.

               (a) Except as otherwise provided in Section 18.1(b) or 18.1(c)
     hereof, as applicable, this Agreement and the Securities may be amended or
     supplemented with the written consent of, and any existing Covenant Breach
     or Event of Default or compliance with any provision of this Agreement or
     the

                                       13
<PAGE>

     Securities may be waived only with the affirmative vote at a meeting, or
     the written consent of, a Majority in Interest of Purchasers.

               (b) Without the consent of every affected Purchaser who is a
     registered owner of shares of Series A Preferred Stock with an aggregate
     Original Issue Price of (pound)500,000 or more, no amendment, supplement or
     waiver to this Agreement shall: (i) reduce the Original Issue Price,
     principal amount or value of the Series A Preferred Stock, the Mirror
     Preferred Stock, the Mirror Notes or the Mirror PIK Notes; (ii) reduce the
     number of shares of Common Stock issuable upon conversion of any shares of
     Series A Preferred Stock (except pursuant to adjustment provisions as
     provided therein), change the fixed maturity of any Mirror Note or Mirror
     PIK Note or alter the provisions with respect to the redemption of the
     Series A Preferred Stock, the Mirror Preferred Stock, the Mirror Note or
     Mirror PIK Note in a manner adverse to the Purchasers; (iii) reduce the
     rate of or change the time for payment of dividends or interest on any
     shares of Series A Preferred Stock, the Mirror Preferred Stock, Mirror Note
     or the Mirror PIK Notes; (iv) waive a Covenant Breach or Event of Default
     in the payment of principal of, or interest on, any shares of Series A
     Preferred Stock, the Mirror Preferred Stock, or Mirror Note or the Mirror
     PIK Note or on the payment of the Series A Purchase Price or Series A
     Preference Amount, or the Mirror Preferred Stock Purchase Price or the
     Mirror Preferred Stock Preference Amount or the Mirror Note Redemption
     Price or the Mirror PIK Note Redemption Price (except that a Majority in
     Interest of the Purchasers may (A) rescind an Acceleration that resulted
     from a non-payment default, and (B) waive the payment default that resulted
     from such Acceleration); (v) make any share of Series A Preferred Stock or
     Mirror Preferred Stock or Mirror Note or Mirror PIK Notes payable in
     consideration other than that stated in the Certificate of Designation or
     such instruments; (vi) waive a payment of the Series A Purchase Price,
     Series A Preference Amount, Mirror Preferred Stock Purchase Price, Mirror
     Preferred Stock Preference Amount, the Mirror Note Redemption Price or the
     Mirror PIK Note Redemption Price, upon redemption or purchase of the
     relevant Security; or (vii) make any change in this Section 18.1(b).

               (c) After an amendment, supplement or waiver under this Section
     18.1 becomes effective, the Companies shall mail to the Purchasers a notice
     briefly describing the amendment, supplement or waiver. Any failure of the
     Companies to mail such notice, or any defect therein, shall not, however,
     in any way impair or affect the validity of any such amended or
     supplemental Agreement or waiver.

         18.2 Revocation and Effect of Consents.

               (a) Until an amendment, supplement or waiver becomes effective, a
     consent to it by the Purchasers is a continuing consent by such Purchasers
     and every subsequent holder of Securities (whether subsequently holding in
     whole or in part), even if notation of the consent is not made on any
     Security.

                                       14
<PAGE>

               (b) The Companies may, but shall not be obligated to, fix a
     record date for the purpose of determining the subsequent holders of
     Securities entitled to consent to any amendment or waiver. If a record date
     is fixed, then notwithstanding the provisions of the immediately preceding
     paragraph, those Persons who were holders of Securities at such record date
     (or their duly designated proxies), and only those Persons, shall be
     entitled to consent to such amendment or waiver or to revoke any consent
     previously given, whether or not such Persons continue to be holders of
     such Securities after such record date.

               (c) After an amendment or waiver becomes effective it shall bind
     the Purchasers and any subsequent holder.

         18.3 Notation on or Exchange of Securities. The Companies may place an
     appropriate notation about an amendment, supplement or waiver on any
     Security thereafter issued in exchange for any Security issued and
     outstanding as of the date of such amendment, supplement or waiver. The
     Companies, in exchange for such issued and outstanding Securities, may
     issue all new Securities that reflect the amendment, supplement or waiver.
     Failure to make the appropriate notation or issue a new Security shall not
     affect the validity and effect of such amendment, supplement or waiver.

         18.4 Board Approval. The Companies may not sign an amendment,
     supplement or waiver with respect to this Agreement until the Board of
     Directors of Transworld approves it.

     12. Amendment to Section 21.10. Effective hereby, the following shall be
substituted in its entirety for Section 21.10. of the Agreement:

         21.10 Merger. This Agreement, the Subordinated Notes, the PIK Notes,
     the Warrant Instrument, the Mirror Notes, the Mirror PIK Notes, the shares
     of Series A Preferred Stock, the Certificate of Designations, the shares of
     Mirror Preferred Stock, and the other Transaction Documents collectively
     constitute the entire agreement of the Companies and the Purchasers and
     express the entire understanding of the Companies and the Purchasers with
     respect to the Securities.

     13. Amendment to Section 21.12. Effective hereby, the following shall be
substituted in its entirety for Section 21.12 of the Agreement:

         21.12 Conflict. If there is a conflict between the provisions of (i)
     this Agreement or the Voting Trust Agreement and (ii) the Charter Documents
     of Transworld, TW UK or UK Parent or any of the other Group Companies
     during the continuance of this Agreement or the Voting Trust Agreement (as
     the case may be), it is the intention of the parties hereto that the
     provisions of this Agreement or the Voting Trust Agreement (as the case may
     be) shall prevail over such Charter Documents during such period and
     accordingly Transworld, the Companies and the Purchasers shall exercise all
     voting and other rights and powers available to them so as to give effect
     to the provisions of this Agreement

                                       15
<PAGE>

     or the Voting Trust Agreement (as the case may be) and shall further if
     necessary procure any required amendment to the Charter Documents of the
     Group Companies.

          14. Tax Covenants of the Companies Applicable to the Purchasers'
Securities. As a material inducement for the Purchasers to enter into this
Amendment and the Master Reorganization Agreement, each of the Companies hereby
makes the following covenants and agreements; provided, however, that all such
covenants and agreements shall, notwithstanding the terms thereof, lapse upon
the Lead Investor (or any of its Affiliates, which, for purposes of this
paragraph 14, shall included any limited partner or other constituent owner of
the Lead Investor) holding none of the shares of Series A Preferred Stock issued
to the Lead Investor on the Closing Date (including shares of Common Stock
issued upon conversion thereof):

         (a) None of the Companies and any of their respective Subsidiaries and
other affiliates shall take any action, or fail to take any action, that would
cause the exchanges set forth in Section 1.1(a), (b), (c)(ii), (d)(ii), and
(e)(ii) of the Master Reorganization Agreement (collectively, the "Tax-Free
Exchanges") not to qualify as a "B" reorganization within the meaning of Section
368(a)(1)(B) of the Code.

         (b) Without limiting the foregoing Section 16(a):

               (i) none of the Companies and any of their respective
     Subsidiaries and other affiliates will file any Tax Return or take any
     position inconsistent with the treatment of the Tax-Free Exchanges as a "B"
     reorganization within the meaning of Section 368(a)(1)(B) of the Code;

               (ii) each of the Companies and their respective Subsidiaries and
     other affiliates will comply with the record keeping and information
     reporting requirements set forth in Treasury Regulations Section 1.368-3;

               (iii) each of the Companies, the Subsidiaries and other
     Affiliates covenant that UK Parent will at all times during the two-year
     period commencing with the Closing Date continue to be an entity that is
     disregarded as separate from its owner for U.S. federal income tax purposes
     as contemplated by Treasury Regulations Section 301.7701-3;

               (iv) each of the Companies, the Subsidiaries and other Affiliates
     covenant that TW UK will at all times during the two-year period commencing
     with the Closing Date continue to be a corporation, as defined under
     Treasury Regulations Section 301.7701-2(b), for U.S. federal income tax
     purposes;

               (v) each of the Companies, the Subsidiaries and other Affiliates
     covenant that the voting trust established pursuant to the Voting Trust
     Agreement will at all times during the two-year period commencing with the
     Closing Date continue to be either an entity that is disregarded as
     separate from its owner as contemplated by Treasury Regulations Section
     301.7701-3 or a grantor trust for U.S. federal income tax purposes;

                                       16
<PAGE>

               (vi) each of the Companies, the Subsidiaries and other Affiliates
     covenant that Transworld will legally and beneficially own 100% of the
     stock TW UK immediately after the consummation of the Reorganization (as
     defined in the Master Reorganization Agreement) either directly or
     indirectly through UK Parent and the voting trust established by the Voting
     Trust Agreement, and Transworld shall at all times during the two-year
     period commencing with the Closing Date retain control of TW UK within the
     meaning of Code Section 368(c)(1);

               (vii) on or prior to the Closing Date, none of Transworld, any of
     its Subsidiaries or other affiliates (including, without limitation, UK
     Parent) will acquire any shares of stock of TW UK other than pursuant to
     the terms of this Agreement;

               (viii) on or prior to the Closing Date, Transworld will treat
     itself, for U.S. federal income tax purposes, as the direct owner of the
     shares of TW UK beneficially owned by UK Parent and legally owned by the
     voting trust established by the Voting Trust Agreement for the two-year
     period commencing with the Closing Date, and shall not file Tax Returns
     relating to such two-year period, including amended Tax Returns,
     inconsistent with such treatment; and

               (ix) TW UK solely shall pay the expenses and taxes required to be
     paid by Section 1.3 of the Master Reorganization Agreement and Section 10.7
     of the Master Reorganization Agreement, such expenses and taxes shall be
     paid out of the operating cash flow and cash balances of TW UK, TW UK shall
     not borrow any amounts or otherwise incur any indebtedness for the purpose
     of or in connection with the paying of any such expenses and taxes, and TW
     UK shall not be reimbursed, directly or indirectly, by Transworld or any of
     the Subsidiaries or other affiliates of Transworld (including, without
     limitation, UK Parent) for any such expenditures.

         (c) Transworld and UK Parent represent and warrant that, at all times
since December 17, 1999, (i) none of Transworld, any of its Subsidiaries and
other affiliates (including, without limitation, UK Parent but excluding TW UK)
has acquired stock of TW UK other than directly from TW UK in connection with
the formation of TW UK; (ii) TW UK acquired shares of its own stock, if any such
acquisitions have occurred, solely with consideration attributable to its own
operating cash flow and cash balances and not with consideration attributable to
a loan or other indebtedness or capital contribution to TW UK; and (iii)
Transworld has treated itself for U.S. federal income tax purposes as the direct
owner of the shares of TW UK beneficially owned by UK Parent and legally owned
by the voting trust established pursuant to the Voting Trust Agreement, and the
voting trust established pursuant to the Voting Trust Agreement has at all times
been either an entity that is disregarded as separate from its owner as
contemplated by Treasury Regulations Section 301.7701-3 or a grantor trust for
U.S. federal income tax purposes.

         (d) None of the Companies and any of their respective Subsidiaries and
other affiliates is aware of any fact that would cause the Tax-Free Exchanges
not to qualify as a "B" reorganization within the meaning of Section
368(a)(1)(B) of the Code.

                                       17
<PAGE>

         (e) Each of the Companies, their Subsidiaries and other Affiliates
represents and warrants that it has no present plan or intention to take any
actions or fail to take any actions that would cause the covenants set forth in
Section 14(b)(iii)-(vi) and (viii) to be violated as if such covenants were not
limited to the two-year period therein.

         (f) None of the Companies, any of their Subsidiaries or other
Affiliates has acquired stock of TWUK in anticipation or contemplation of the
Tax-Free Exchange.

     15. Directors. Each of Transworld and UK Parent hereby agrees to use its
best efforts to nominate for director(s) of Transworld and UK Parent,
respectively, at any instance whereupon a vote or selection for such director(s)
shall occur, including without limitation, at each meeting of the stockholders
of TW UK and UK Parent, respectively (or in each action by written consent in
lieu of a meeting), for the election of director or upon the creation of or
existence of any vacancy in the Board of Directors, those individuals as
appropriate such that the Board of Directors of Transworld and UK Parent,
respectively, will be comprised identically to the Board of Directors of TW UK.

     16. Other Provisions Unchanged. Except as specifically amended hereby, all
other terms and conditions of the Agreement shall remain in full force and
effect. To the extent that the Agreement includes such terms as "herein,"
"hereto," "in this Agreement" and the like, such terms shall be interpreted to
refer to the Agreement, as modified by this Amendment.

     17. Counterparts. This Amendment may be executed in separate counterparts,
each of which shall be an original and all of which taken together shall
constitute one and the same instruments.

                [REMAINDER OF THIS PAGE INTENTIONALLY LEFT BLANK]

                                       18
<PAGE>

     IN WITNESS WHEREOF, the parties hereto have executed and delivered this
Amendment to the Agreement on the date first written above.

                                       COMPANIES:

                                       SIGNED AS A DEED FOR AND ON BEHALF OF
                                       TRANSWORLD HEALTHCARE (UK) LIMITED

                                       By: /s/ Tim Aitken
                                           -------------------------------------
                                           Name:
                                           Title:

                                       SIGNED AS A DEED FOR AND ON BEHALF OF
                                       ALLIED HEALTHCARE GROUP LIMITED,
                                       FORMERLY KNOWN AS
                                       TRANSWORLD HOLDINGS (UK) LIMITED,

                                       By: /s/ Tim Aitken
                                           -------------------------------------
                                           Name:
                                           Title:

<PAGE>

                            PURCHASERS:

                            SIGNED AS A DEED FOR AND ON BEHALF OF
                            TRIUMPH PARTNERS III, L.P.

                            By: Triumph III Advisors, Inc., its general partner

                            By: /s/ Carl M. Youngman
                                ------------------------------------------------
                                Name: Carl M. Youngman
                                Title: Managing Director

                            By:
                               -------------------------------------------------
                               Name:
                               Title:

                            SIGNED AS A DEED FOR AND ON BEHALF OF
                            TRIUMPH III INVESTORS, L.P.

                            By: Triumph III Investors, Inc., its general partner

                            By: /s/ Carl M. Youngman
                                ------------------------------------------------
                                Name: Carl M. Youngman
                                Title: Managing Director

<PAGE>

                                       SIGNED AS A DEED BY
                                       ALLIED HEALTHCARE INTERNATIONAL INC.,
                                       FORMERLY KNOWN AS TRANSWORLD
                                       HEALTHCARE, INC.,
                                       ACTING BY ITS DULY AUTHORIZED ATTORNEY

                                       By: /s/ John B. Wynne
                                           -------------------------------------
                                           Name:
                                           Title:

<PAGE>

                               SIGNED AS A DEED FOR AND ON
                               BEHALF OF: AITKEN (ENGLISH) COMPANY LIMITED
                               ACTING BY ITS DULY AUTHORIZED ATTORNEY:

                               By: /s/ Tim Aitken
                                   ---------------------------------------------
                                   Name:
                                        ----------------------------------------
                                   Title: Chairman

                               SIGNED AS A DEED BY:

                               /s/ Tim Aitken
                               -------------------------------------------------
                               Timothy M. Aitken

                               SIGNED AS A DEED BY:

                               /s/ Sarah L. Eames
                               -------------------------------------------------
                               Sarah L. Eames

                               SIGNED AS A DEED BY:

                               /s/ Charles Murphy
                               -------------------------------------------------
                               Charles Kernahan, by his duly authorized Attorney

                               SIGNED AS A DEED BY:

                               /s/ Charles Murphy
                               -------------------------------------------------
                               David Johnson, by his duly authorized Attorney

                               SIGNED AS A DEED BY:

                               /s/ Charles Murphy
                               -------------------------------------------------
                               Charles Murphy

<PAGE>

                               SIGNED AS A DEED BY:

                               /s/ Charles Murphy
                               -------------------------------------------------
                               Wayne Palladino, by his duly authorized Attorney

                               SIGNED AS A DEED BY:

                               /s/ Charles Murphy
                               -------------------------------------------------
                               Steven Gullick, by his duly authorized Attorney

                               SIGNED AS A DEED BY AND ON BEHALF OF:
                               ZRH NOMINEES (0051) LIMITED
                               ACTING BY ITS DULY AUTHORIZED ATTORNEY

                               By: /s/ Charles Murphy
                                   ---------------------------------------------
                                   Name: Charles Murphy
                                   Title: Group Finance Director

                               SIGNED AS A DEED BY AND ON BEHALF OF:
                               ORION NOMINEES LIMITED
                               ACTING BY ITS DULY AUTHORIZED ATTORNEY

                               By: /s/ Charles Murphy
                                   ---------------------------------------------
                                   Name: Charles Murphy
                                   Title: Group Finance Director

<PAGE>

                                   SIGNED AS A DEED BY AND ON BEHALF OF:
                                   BNP PARIBAS
                                   ACTING BY ITS DULY AUTHORIZED ATTORNEY:

                                   By: /s/ Leo Leslie      /s/ Don Ercole
                                       -----------------------------------------
                                   Name:   Leo Leslie           Don Ercole
                                   Title:
                                         ---------------------------------------

                                   SIGNED AS A DEED BY AND ON BEHALF OF:
                                   BAYERISCHE HYPO-UND VEIRENSBANK AG
                                   ACTING BY ITS DULY AUTHORIZED ATTORNEY

                                   By: /s/ Ray Daws        /s/ Guy Beeston
                                       -----------------------------------------
                                   Name:   Ray Daws            Guy Beeston
                                   Title:  V.P.                V.P.
                                           -------------------------------------

                                   SIGNED AS A DEED BY AND ON BEHALF OF:
                                   NMB HELLER
                                   ACTING BY ITS DULY AUTHORIZED ATTORNEY

                                   By: /s/ J.P. Onslow
                                       -----------------------------------------
                                   Name: J.P. Onslow
                                   Title: Director<PAGE>

                                                                    EXHIBIT 10.5

                          REGISTRATION RIGHTS AGREEMENT

                                  BY AND AMONG

                      ALLIED HEALTHCARE INTERNATIONAL INC.

                                       AND

                            THE HOLDERS NAMED HEREIN

                            DATED AS OF JULY 25, 2002

<PAGE>

                          REGISTRATION RIGHTS AGREEMENT

     THIS REGISTRATION RIGHTS AGREEMENT (this "Agreement") is entered into as of
July 25, 2002, by and among Allied Healthcare International Inc. (f/k/a
Transworld Healthcare, Inc.), a New York corporation ("TWUS"), the holders of
ordinary shares of Transworld Healthcare (UK) Limited, a company incorporated in
England and Wales with registered number 3370146 ("TWUK"), named in Exhibit A
attached hereto (the "Ordinary Shareholders," and each individually, an
"Ordinary Shareholder"), Triumph Partners III, L.P. and Triumph III Investors,
L.P. (together "Triumph"), the holders of redeemable shares of TWUK named in
Exhibit B attached hereto (the "Redeemable Shareholders," and, each
individually, a "Redeemable Shareholder"), the holders of equity warrants of
TWUK named in Exhibit C attached hereto (the "Equity Warrant Holders," and each
individually, an "Equity Warrant Holder"), the holders of mezzanine warrants of
TWUK named in Exhibit D attached hereto (the "Mezzanine Warrant Holders," and
each individually, a "Mezzanine Warrant Holder"), Hyperion Partners II L.P.,
Hyperion TW Fund L.P., Hyperion TWH Fund LLC, and Hyperion TWH Fund II LLC
(collectively, "Hyperion"), Timothy M. Aitken and Sarah L. Eames (together, the
"Employees") and BNP Paribas ("Paribas"). The Ordinary Shareholders, Triumph,
the Redeemable Shareholders, the Equity Warrant Holders and the Mezzanine
Warrant Holders shall be referred to collectively herein as the "Investors." The
Investors, Hyperion, Triumph, the Employees and Paribas, collectively, the
"Holders" and each individually a "Holder."

                                    RECITALS

     WHEREAS, the Investors are to receive an aggregate of up to 2,358,930
shares (the "Investor Shares") of TWUS common stock, par value $.01 per share
("TWUS Common Stock"), and the Equity Warrant Holders are to receive an
aggregate of up to 7,773,660 shares of TWUS preferred stock, par value $.01 per
share ("TWUS Preferred Stock"), which are convertible into shares of common
stock of TWUS (the "Conversion Shares"), pursuant to the terms of that certain
Master Reorganization Agreement, dated as of April 24, 2002 by and among TWUS,
TWUK, Allied Healthcare Group (UK) Ltd., a company incorporated in England and
Wales with registered number 3890177 ("AHG," and, together with TWUS and TWUK,
the "Corporate Group") and the Investors (as subsequently amended, the
"Reorganization Agreement");

     WHEREAS, dividends on the TWUS Preferred Stock may under certain
circumstances be paid through the delivery of additional shares of TWUS Common
Stock (the "Dividend Shares");

     WHEREAS, it is a condition to the obligations of the Investors that TWUS
grant certain registration rights to the Investors with respect to the Investor
Shares, the Conversion Shares and the Dividend Shares to be received by the
Investors;

     WHEREAS, TWUS has agreed to grant certain registration rights to Hyperion
in connection with the shares of TWUS Common Stock held by Hyperion as of the
date hereof (the "Hyperion Shares");

<PAGE>

     WHEREAS, TWUS has agreed to grant certain registration rights to Triumph in
connection with the 370,500 shares of TWUS Common Stock purchased by Triumph
Partners III, L.P. on April 22, 2002 and the 4,500 shares of TWUS Common Stock
purchased by Triumph III Investors, L.P. on April 22, 2002 (together, but not
including the Paribas Shares, the "Triumph Shares");

     WHEREAS, TWUS has agreed to grant certain registration rights to Paribas in
connection with the 75,000 of the Triumph Shares purchased from Triumph by
Paribas on June 7, 2002 (the "Paribas Shares"); and

     WHEREAS, TWUS has agreed to grant certain registration rights to the
Employees in connection with the 684,258 shares of TWUS Common Stock issued to
Timothy Aitken on April 22, 2002 and the 487,099 shares of TWUS Common Stock
issued to Sarah Eames on April 22, 2002 (the "Compensatory Shares");

     NOW, THEREFORE, in consideration of the foregoing, the mutual promises and
agreements set forth herein, and other valuable consideration, the receipt and
sufficiency of which are hereby acknowledged, the parties hereto hereby agree as
follows:

     1. CERTAIN DEFINITIONS.

     As used in this Agreement, the following terms shall have the following
respective meanings:

     "Affiliate" of a Person shall mean any person or entity which directly or
indirectly controls, is controlled by, or is under common control with such
person or entity.

     "Affiliate Registration Statement" shall have the meaning set forth in
Section 2(b) hereof.

     "Agreement" shall have the meaning set forth in the preamble hereof.

     "AHG" shall have the meaning set forth in the recitals hereof.

     "AMEX" shall have the meaning set forth in Section 4 hereof.

     "Arbitrator" shall have the meaning set forth in Section 17(a) hereof.

     "Closing" shall have the meaning ascribed thereto in the Reorganization
Agreement.

     "Commission" shall mean the United States Securities and Exchange
Commission, or any other federal agency administering the Securities Act and the
Exchange Act at the time.

     "Compensatory Shares" shall have the meaning set forth in the recitals
hereof.

     "Conversion Shares" shall have the meaning set forth in the recitals
hereof.

                                       2
<PAGE>

     "Corporate Group" shall have the meaning set forth in the recitals hereof.

     "Demand Notice" shall have the meaning set forth in Section 2(d) hereof.

     "Demand Registration" shall have the meaning set forth in Section 2(d)
hereof.

     "Dividend Shares" shall have the meaning set forth in the recitals hereof.

     "Employees" shall have the meaning set forth in the recitals hereof.

     "Equity Warrant Holder(s)" shall have the meaning set forth in the preamble
hereof.

     "Exchange Act" shall mean the Securities Exchange Act of 1934, as amended
from time to time, or any similar successor federal statute, and the rules and
regulations promulgated thereunder.

     "Fair Market Value" shall mean the closing sales price, or the closing
sales bid if no sales were reported, of the TWUS Common Stock as quoted on AMEX
on the date immediately preceding the date of calculation or if there are no
sales or bids for such date, then for the last preceding business day for such
sales or bids, as reported in The Wall Street Journal or similar publication.

     "Holder(s)" shall have the meaning set forth in the preamble hereof.

     "Hyperion" shall have the meaning set forth in the preamble hereof.

     "Hyperion Shares" shall have the meaning set forth in the recitals hereof.

     "Indemnified Person" shall have the meaning set forth in Sections 6(a) and
6(b) hereof.

     "Indemnifying Person" shall have the meaning set forth in Section 6(d)
hereof.

     "Indemnitee" shall have the meaning set forth in Section 6 hereof.

     "Inspectors" shall have the meaning set forth in Section 3(k) hereof.

     "Investors" shall have the meaning set forth in the preamble hereof.

     "Investors' Shares" shall have the meaning set forth in the recitals
hereof. For purposes of clarity, "Investor Shares" shall include those shares of
TWUS Common Stock delivered in exchange for the Unpaid PIK Interest (as defined
in the Reorganization Agreement) of the Triumph Investors (as defined in the
Reorganization Agreement) pursuant to Section 1.1(g)(iii) of the Reorganization
Agreement.

     "Liability" shall have the meaning set forth in Section 6(a) hereof.

                                       3
<PAGE>

     "Majority in Interest" shall mean, (i) subject to clause (ii) hereof, with
respect to the registrations subject to Section 2(a) (or a demand registration
in lieu thereof) and with respect to Section 9(i), the meaning ascribed thereto
in the Reorganization Agreement, (ii) with respect to a registration pursuant to
the last sentence of Section 2(b), both a Majority in Interest of the Investors
(as defined in the Reorganization Agreement) and a majority in interest of the
Hyperion Shares, Compensatory Shares, Triumph Shares and Paribas Shares proposed
to be registered under such Registration Statement and (iii) with respect to any
other registration, a majority of the Registrable Shares proposed to be
registered under such Registration Statement.

     "Mezzanine Warrant Holder(s)" shall have the meaning set forth in the
preamble hereof.

     "NASD" shall have the meaning set forth in the Section 3(q) hereof.

     "Offering Blackout Period" shall have the meaning set forth in the Section
10(c) hereof.

     "Ordinary Shareholder(s)" shall have the meaning set forth in the preamble
hereof.

     "Paribas" shall have the meaning set forth in the preamble hereof.

     "Paribas Shares" shall have the meaning set forth in the recitals hereof.

     "Person" shall mean an individual, a corporation, a partnership, a joint
venture, a trust, an unincorporated organization, a limited liability company or
partnership, a government and any agency or political subdivision thereof.

     "Prospectus" shall mean the prospectus included in a Registration
Statement, including any preliminary prospectus, as amended or supplemented by
any prospectus supplement with respect to the terms of the offering of any
portion of the Registrable Shares covered by such Registration Statement, and by
all other amendments and supplements to such prospectus, including
post-effective amendments, and in each case including all material incorporated
by reference therein.

     "Qualified Offering" shall have the meaning set forth in Section 2(e)(ii)
hereof.

     "Records" shall have the meaning set forth in Section 3(k) hereof

     "Redeemable Shareholder(s)" shall have the meaning set forth in the
preamble hereof.

     "Registrable Shares" shall mean the Shares, excluding (i) Shares for which
a Registration Statement relating to the resale thereof by the holder thereof
shall have become effective under the Securities Act and which have been
disposed of under such Registration Statement, (ii) Shares actually sold
pursuant to Rule 144, or (iii) the Shares of any holder that (x) owns Shares
equal to less than one percent (1%) of the outstanding voting stock of the
Company (on an as converted basis) and (y) is able to offer for sale all of its
Shares within a given three month period pursuant to Rule 144 (or any successor
provision) without giving effect to paragraph (k) thereof.

                                       4
<PAGE>

     "Registration Expenses" shall mean the expenses so described in Section 5
hereof.

     "Registration Statement" shall mean any registration statement of TWUS
which covers the offer and sale of any of the Registrable Shares under the
Securities Act on an appropriate form, and all amendments and supplements to
such registration statement, including post-effective amendments, in each case
including the Prospectus contained therein, all exhibits thereto and all
materials incorporated by reference therein.

     "Reorganization" shall have the meaning set forth in Section 2(a) hereof.

     "Reorganization Agreement" shall have the meaning set forth in the recitals
hereof.

     "Resale Registration Statement" shall have the meaning set forth in Section
2(a) hereof.

     "Rule 144" means Rule 144 under the Securities Act (or any successor
provision).

     "Securities Act" shall mean the Securities Act of 1933, as amended from
time to time, or any similar successor federal statute, and the rules and
regulations of the Commission thereunder.

     "Shares" shall mean collectively the Investors' Shares, the Conversion
Shares, the Dividend Shares, the Hyperion Shares, the Compensatory Shares, the
Triumph Shares and the Paribas Shares.

     "Suspension Event" shall have the meaning set forth in Section 10(b)
hereof.

     "Triumph" shall have the meaning set forth in the preamble hereof.

     "Triumph Shares" shall have the meaning set forth in the recitals hereof.

     "TWUK" shall have the meaning set forth in the preamble hereof.

     "TWUS" shall have the meaning set forth in the preamble hereof.

     "TWUS Common Stock" shall have the meaning set forth in the recitals
hereof.

     "TWUS Offering" shall have the meaning set forth in the Section 10(c)
hereof.

     "TWUS Preferred Stock" shall have the meaning set forth in the recitals
hereof.

     All other capitalized terms not defined herein shall have the meaning set
forth in the Reorganization Agreement unless otherwise indicated.

                                       5
<PAGE>

     2. REGISTRATION.

         (a) Amendment of Registration Statement. Subject to the provisions of
Section 2(c) below, TWUS shall (i) originally file with the Commission its
Registration Statement on Form S-4 covering the issuance of Shares in the
reorganization of the Corporate Group pursuant to which TWUK will become a
wholly-owned subsidiary of AHG, which is a wholly-owned subsidiary of TWUS (the
"Reorganization"), to also serve after the consummation of the Reorganization as
a resale registration statement under Rule 415 covering the sale by the
Investors of all or any portion of their Registrable Shares (other than the
Compensatory Shares, the Triumph Shares and the Paribas Shares), or (ii) if TWUS
is unable to comply with clause (i) above for any reason, prepare and file a
resale registration statement on Form S-3, or such other applicable forms, with
the Commission, under Rule 415 under the Securities Act, covering the sale by
the Investors of all or any portion of their Registrable Shares in accordance
with the terms hereof (each of the registration statement(s) described in
clauses (i) and (ii) above hereafter a "Resale Registration Statement"). A
filing described in clause (ii) above shall be made on a date reasonably
designed to allow TWUS to have such Registration Statement declared effective by
the date of the Closing of the Reorganization, but in any event such Resale
Registration Statement shall be declared effective not later than thirty (30)
calendar days after the Closing of the Reorganization. TWUS shall use its
reasonable best efforts to cause the Resale Registration Statement to be
declared effective by the Commission for all of the Registrable Shares covered
thereby by the earliest practicable date after filing with the Commission. In
the event that TWUS is unable to cause such Resale Registration Statement to be
declared effective by the Commission within thirty (30) calendar days following
the Closing of the Reorganization, then the provisions of Section 2(c) shall
apply. TWUS agrees to use its reasonable efforts to keep the Resale Registration
Statement continuously effective until no shares of TWUS Preferred Stock remain
outstanding and no Investors' Shares, Conversion Shares or Dividend Shares that
constitute Registrable Shares remain outstanding. In the event that a Person not
named in a Resale Registration Statement as a potential selling stockholder
becomes a Holder of Registrable Shares, TWUS will make such changes to the then
effective Resale Registration Statement as are necessary to include such Person
as a potential selling stockholder with respect to its Registrable Shares under
the Resale Registration Statement, unless the inclusion of such Person is
prohibited by the Commission or applicable law.

         (b) Registration Statement Covering Resale of Hyperion Shares,
Compensatory Shares, Triumph Shares and Paribas Shares. TWUS shall prepare and
file a registration statement on Form S-3 (the "Affiliate Registration
Statement"), or such other applicable forms, with the Commission, under Rule 415
under the Securities Act, in connection with the sale by Hyperion, the
Employees, Triumph and Paribas at the time of such filing of all of the Hyperion
Shares, the Compensatory Shares, the Triumph Shares and the Paribas Shares in
accordance with the terms hereof (and, in the event that a Person not named in
an Affiliate Registration Statement as a potential selling stockholder becomes a
Holder of Hyperion Shares, Compensatory Shares, Triumph Shares or Paribas
Shares, TWUS will make such changes to the then effective Affiliate Registration
Statement as are necessary to include such Person as a potential selling
stockholder with respect to its Hyperion Shares, Compensatory Shares, Triumph
Shares or Paribas Shares under the Affiliate Registration Statement, unless the
inclusion of such

                                       6
<PAGE>

Person is prohibited by the Commission or applicable law), such filing to be
made on a date reasonably designed to allow TWUS to have such Affiliate
Registration Statement declared effective by the date of the Closing of the
Reorganization, but in any event such Affiliate Registration Statement shall be
declared effective not later than thirty (30) calendar days after the Closing of
the Reorganization. TWUS shall use its reasonable best efforts to cause the
Affiliate Registration Statement to be declared effective by the Commission for
all of the Registrable Shares covered thereby by the earliest practicable date
after filing with the Commission. In the event that TWUS is unable to cause such
Affiliate Registration Statement to be declared effective by the Commission
within thirty (30) calendar days following the Closing of the Reorganization,
then the provisions of Section 2(c) shall apply. TWUS agrees to use its
reasonable efforts to keep the Affiliate Registration Statement continuously
effective until no Hyperion Shares, Compensatory Shares, Triumph Shares or
Paribas Shares that constitute Registrable Shares remain outstanding.
Notwithstanding anything to the contrary contained in this Agreement, TWUS shall
be entitled to satisfy its obligation to file a Resale Registration Statement
pursuant to Section 2(a) and its obligation to file an Affiliate Registration
Statement pursuant to this Section 2(b) by filing a single registration
statement that otherwise complies with the requirements of Sections 2(a) and
2(b).

         (c) Demand Registration. In the event that, for any reason, TWUS is
unable to cause a Resale Registration Statement or an Affiliate Registration
Statement to be declared effective by the Commission within thirty (30) days
following the Closing of the Reorganization or is unable or it is impracticable
to keep such Resale Registration Statement or Affiliate Registration Statement
continuously effective for the period set forth in Section 2(a) or 2(b), as
applicable, TWUS shall, within ten (10) days after TWUS makes such determination
or such shorter period as the Commission may provide to TWUS in the event such
event involves an action or determination by the Commission (in which case TWUS
shall immediately forward to the Investors, Hyperion, Triumph, the Employees and
Paribas copies of all relevant correspondence to and from the Commission), give
notice to the Investors, Hyperion, Triumph, the Employees and Paribas, as the
case may be, of such fact and of the circumstances giving rise to such inability
or impracticability, so as to enable the Investors, Hyperion, Triumph, the
Employees and Paribas to exercise their rights as set for in this Section 2(c).
At any time any shares of TWUS Preferred Stock or Registrable Shares are
outstanding and a Resale Registration Statement or an Affiliate Registration
Statement, as applicable, covering the resale of their respective Registrable
Shares is not effective, TWUS shall, at the written request of any Investor,
Hyperion, Triumph, the Employees or Paribas (and their permitted transferees and
assigns), as the case may be (a "Demand Notice"), cause to be filed as soon as
practicable after the date of such request a Registration Statement in
accordance with Rule 415 under the Securities Act (or such other rule as is
applicable to the proposed sale) relating to the resale by such Investor,
Hyperion, Triumph, the Employees or Paribas (and their permitted transferees and
assigns) of all or any portion of the Registrable Shares held by such Investor
(including Conversion Shares and/or Dividend Shares issuable to such Investor),
Hyperion, Triumph, the Employees or Paribas (and their permitted transferees and
assigns) in accordance with the terms hereof, and shall use its reasonable best
efforts to cause such Registration Statement to be declared effective by the
Commission as soon as practicable thereafter (a "Demand Registration");
provided, however, that TWUS shall not be required to file such Registration
Statement unless the number of Registrable Shares included in such Demand Notice
have a Fair Market Value in excess of

                                       7
<PAGE>

$1,000,000. TWUS agrees to use its reasonable best efforts to keep the Demand
Registration continuously effective, after its date of effectiveness, with
respect to the Registrable Shares of the requesting Investor, Hyperion, Triumph,
the Employees or Paribas (and their permitted transferees and assigns) until the
date on which such Investor, Hyperion, Triumph, the Employees or Paribas (and
their permitted transferees and assigns) no longer holds any Registrable Shares.

          (d) Underwritten Offering. If one or more Holders shall propose to
          sell Registrable Shares in an underwritten offering pursuant to a
          Registration Statement filed under Section 2 hereof, such Holders
          shall be entitled to select one (1) lead underwriter for such offering
          (selected by a Majority in Interest of the Holders of the Registrable
          Shares proposed to be included in such underwritten offering), which
          selection shall be reasonably satisfactory to TWUS. At TWUS' option,
          following such selection and approval of a lead underwriter by the
          Holders, TWUS shall be entitled to select a co-lead underwriter with
          respect to such underwritten offering (and both such underwriters
          shall accordingly be co-leads; provided that the underwriter
          designated by the Holders shall be responsible for maintaining the
          order book with respect to such offering).

          (ii) If one or more Holders propose to sell in an underwritten
          offering Registrable Shares which have an aggregate Fair Market Value
          of $5,000,000 or more (a "Qualified Offering"), then TWUS shall make
          available members of the management of TWUS and its Affiliates for
          reasonable assistance in selling efforts related to such offering
          (including, without limitation, senior management attendance at due
          diligence meetings with underwriters and their counsel and road shows)
          and shall enter into underwriting agreements containing usual and
          customary terms and conditions for such types of offerings (including,
          but not limited to, indemnification terms customary therein) and take
          all such other reasonable actions in connection therewith in order to
          expedite or facilitate the disposition of such Registrable Shares,
          including without limitation: (A) make such representations and
          warranties to the underwriters with respect to the business of TWUS,
          the Registration Statement, the Prospectus and any documents, if any,
          incorporated or deemed to be incorporated by reference therein, as may
          reasonably be required by the underwriters; (B) obtain opinions of
          counsel to TWUS and updates thereof, addressed to the Holders and each
          of the underwriters; (C) obtain "cold comfort" letters and updates
          thereof from the independent certified public accountants of TWUS
          addressed to the Holders and each of the underwriters; (D) ensure
          that, if an underwriting agreement is entered into, such agreement
          shall contain indemnification provisions and procedures that are usual
          and customary for an offering of such size; and (E) deliver such
          documents and certificates as may be reasonably requested by the
          underwriters and their respective counsel to evidence the continued
          validity of the representations and warranties made pursuant to clause
          (A) of this Section 2(d)(ii).

                                       8
<PAGE>

     3. Registration Procedures. When TWUS is required pursuant to the
provisions of this Agreement to effect the registration of any of the Shares
under the Securities Act, TWUS will:

         (a) prepare and file with the Commission a Registration Statement on
the appropriate form under the Securities Act with respect to such securities,
which form shall comply in all material respects with the requirements of the
applicable form and include all financial statements required by the Commission
to be filed therewith, and use its reasonable best efforts to cause such
Registration Statement to become and remain effective until completion of the
proposed offering;

         (b) prepare and file with the Commission such amendments and
supplements to such Registration Statement and the Prospectus used in connection
therewith as may be necessary to keep such Registration Statement effective
until the Holders shall have completed the sales described in such Registration
Statement and to comply with the provisions of the Securities Act with respect
to the sale or other disposition of all securities covered by such Registration
Statement whenever the seller or sellers of such securities shall desire to sell
or otherwise dispose of the same, but only to the extent provided in this
Agreement

         (c) furnish to the Holders and the underwriters, if any, such number of
copies of any Registration Statement, any amendments thereto, any documents
incorporated by reference therein, the Prospectus, including a preliminary
prospectus in conformity with the requirements of the Securities Act, and such
other documents as the Holders or underwriters may reasonably request in order
to facilitate the public sale or other disposition of the Shares owned by the
Holders or underwriters;

         (d) file and use its reasonable best efforts to register or qualify the
Shares covered by such Registration Statement under such other securities or
state securities or "blue sky" laws of such jurisdictions as the Holders shall
request, and do any and all other acts and things that may be necessary under
such state securities or "blue sky" laws to enable the Holders to consummate the
public sale or other disposition in such jurisdictions of the Shares owned by
such Holder, except that TWUS shall not for any such purpose be required to
qualify to do business as a foreign corporation in any jurisdiction wherein it
is not so qualified;

         (e) within a reasonable time before each filing of a Registration
Statement or Prospectus or amendments or supplements thereto with the
Commission, furnish to counsel selected by the Holders of a Majority in Interest
of the Registrable Shares participating in such registration, copies of such
documents proposed to be filed, which documents shall be subject to the
reasonable approval of such counsel; provided, however, in the event that any of
the Registrable Shares participating include Hyperion Shares and/or Triumph
Shares, counsel to Hyperion and/or Triumph, as applicable, shall also be
furnished copies of such documents proposed to be filed, which documents shall
also be subject to the reasonable approval of such counsel(s);

                                       9
<PAGE>

         (f) immediately notify the Holders, their respective counsel and any
underwriter and (if requested by any such Person) confirm such notice in
writing, of the happening of any event which makes any statement made in a
Registration Statement or related Prospectus untrue or that requires the making
of any changes in such Registration Statement or Prospectus so that they will
not contain any untrue statement of a material fact or omit to state any
material fact required to be stated therein or necessary to make the statements
therein in the light of the circumstances under which they were made not
misleading; and, as promptly as practicable thereafter, prepare and file with
the Commission and furnish a supplement or amendment to such Registration
Statement or Prospectus so that, as thereafter deliverable to the purchasers of
such Registrable Shares, such Registration Statement or Prospectus will not
contain any untrue statement of a material fact or omit to state a material fact
necessary to make the statements therein, in the light of the circumstances
under which they were made, not misleading;

         (g) make generally available to the Holders an earnings statement
satisfying the provisions of Section 11(a) of the Securities Act no later than
sixty (60) days after the end of the 12-month period beginning with the first
day of TWUS' first fiscal quarter commencing after the effective date of a
Registration Statement, which earnings statement shall cover said 12-month
period, and which requirement will be deemed to be satisfied if TWUS satisfies
the requirements of Rule 158 under the Securities Act and otherwise complies
with all applicable rules and regulations of the Commission;

         (h) use its reasonable best efforts to prevent the issuance of any
order suspending the effectiveness of a Registration Statement, and if one is
issued, use its reasonable best efforts to obtain the withdrawal of any order
suspending the effectiveness of a Registration Statement at the earliest
possible moment; provided, however, that TWUS may postpone the filing or
effectiveness of any Registration Statement required to be filed hereunder for a
reasonable period of time, not to exceed ninety (90) days in the aggregate
during any 12-month period, if the TWUS has been advised by legal counsel that
such filing or effectiveness would require a special audit or the disclosure of
a material impending transaction or other matter and TWUS' Board of Directors
determines reasonably and in good faith that such disclosure would have a
material adverse effect on TWUS;

         (i) use its reasonable best efforts to cause, to the extent applicable,
the Registrable Shares covered by a Registration Statement to be registered with
or approved by such other governmental agencies or authorities and to obtain
such approvals, consents and make such filings as may be necessary by virtue of
the business and operations of TWUS to enable the Holders to consummate the
disposition of such Registrable Shares in accordance with their intended method
of distribution thereof;

         (j) if requested by the managing underwriter or underwriters (if any),
a Holder or their respective counsel, promptly incorporate into a Prospectus
supplement or post-effective amendment such information as such Person requests
to be included therein, including, without limitation, with respect to the
Shares being sold by such Holder to such

                                       10
<PAGE>

underwriter or underwriters, the purchase price being paid therefor by such
underwriter or underwriters and any other terms of an underwritten offering of
the Shares to be sold in such offering, and promptly make all required filings
of such prospectus supplement or post-effective amendment;

         (k) subject to appropriate confidentiality agreements, make available
to each Holder, any underwriter participating in any disposition pursuant to a
Registration Statement, and any attorney, accountant or other agent or
representative retained by any such Holder or underwriter (collectively, the
"Inspectors"), all financial and other records, pertinent corporate documents
and properties of TWUS (collectively, the "Records") reasonably necessary to
enable them to exercise their due diligence responsibility, and cause TWUS'
officers, directors and employees to supply all information requested by any
such Inspector in connection with such Registration Statement;

         (l) enter into such customary agreements (including, if applicable, an
underwriting agreement in customary form) and take such other actions as the
Holders or the underwriters retained by the Holders participating in an
underwritten public offering, if any, may reasonably request in order to
expedite or facilitate the disposition of Registrable Shares (and the Holders
may, at their option, require that any or all of the representations, warranties
and covenants of TWUS to or for the benefit of any underwriters also be made to
and for the benefit of the Holders);

         (m) furnish to each prospective selling Holder a signed counterpart,
addressed to the prospective selling Holder, of (i) an opinion of counsel for
TWUS, dated the effective date of the Registration Statement, and (ii) a
"comfort" letter signed by the independent public accountants who have certified
TWUS' financial statements included in the Registration Statement, covering
substantially the same matters with respect to the Registration Statement (and
the Prospectus included therein) and (in the case of the accountants' letter)
with respect to events subsequent to the date of the financial statements, as
are customarily covered (at the time of such registration) in opinions of TWUS'
counsel and in accountants' letters delivered to the underwriters in
underwritten public offerings of securities;

         (n) cause the Shares covered by such Registration Statement to be
listed on the national securities exchange or quoted on the quotation system on
which the TWUS Common Stock is then listed or quoted;

         (o) in connection with an underwritten offering, participate, to the
extent reasonably requested by the managing underwriter for the offering or the
Holders, in customary efforts to sell the Shares being offered, and cause such
steps to be taken as to ensure such good faith participation of senior
management officers of TWUS in "road shows" as is customary;

                                       11
<PAGE>

         (p) if the Registrable Shares are of a class of securities that is
listed on a national securities exchange, file copies of any Prospectus with
such exchange in compliance with Rule 153 under the Securities Act so that the
holders of Registrable Shares benefit from the Prospectus delivery procedures
described therein;

         (q) cooperate with each Holder and each underwriter participating in
the disposition of Registrable Shares and their respective counsel in connection
with any filings required to be made with the National Association of Securities
Dealers, Inc. ("NASD"), including, if appropriate, the pre-filing of a
Prospectus as part of a shelf registration statement in advance of an
underwritten offering;

         (r) otherwise cooperate with the underwriter(s), the Commission and
other regulatory agencies and take all actions and execute and deliver or cause
to be executed and delivered all documents necessary to effect the registration
and sale of any Registrable Shares under this Agreement;

         (s) correct any deficiency (in the judgment of either TWUS or the
Holders of Registrable Shares acting reasonably) between the preliminary
Prospectus and the final Prospectus, and pay any expenses associated with the
recirculation of the final Prospectus following the correction of such
deficiency, if required;

         (t) during the period when the Prospectus is required to be delivered
under the Securities Act, promptly file all documents required to be filed with
the Commission, including pursuant to Sections 13(a), 13(c), 14, or 15(d) of the
Exchange Act; and

         (u) provide a transfer agent and registrar for all Registrable Shares
registered pursuant hereunder and a CUSIP number for all such Registrable
Shares, in each case no later than the effective date of such registration.

     If any Registration Statement refers to any Holder by name or otherwise as
the holder of any securities of TWUS, then such Holder shall have the right to
require (i) the insertion therein of language, in form and substance reasonably
satisfactory to such Holder, to the effect that the holding by such Holder of
such securities is not to be construed as a recommendation by such Holder of the
investment quality of TWUS' securities covered thereby and that such holding
does not imply that such Holder will assist in meeting any future financial
requirements of TWUS, or (ii) in the event that such reference to such Holder by
name or otherwise is not required by the Securities Act or any similar Federal
or state securities or "blue sky" statute and the rules and regulations
thereunder then in force, deletion of the reference to such Holder.

     4. LISTING. TWUS will use reasonable efforts to cause all Registrable
Shares to be listed or otherwise eligible for full trading privileges on the
principal national securities exchange (currently the American Stock Exchange
("AMEX")) on which the TWUS Common

                                       12
<PAGE>

Stock are then listed, in each case not later than the date on which a
Registration Statement covering the Registrable Shares becomes effective or the
Registrable Shares are issued by TWUS to a Holder, whichever is later. TWUS will
use reasonable efforts to continue the listing or trading privilege for all
Registrable Shares on such exchange. TWUS will promptly notify the Holders of,
and confirm in writing, the delisting of TWUS Common Stock by such exchange.

     5. EXPENSES. All expenses incurred by TWUS or the Holders in effecting the
registrations provided for in Section 2, including, without limitation, all
registration and filing fees, printing expenses, fees and disbursements of
counsel for TWUS and of a single counsel for the Holders participating in such
registration as a group (selected by, in the case of a registration under
Section 2(c) (other than a registration pursuant to the last sentence of Section
2(b)), the Holders of a Majority in Interest of the Registrable Shares who
initiate the registration under such Section 2(c), and, in the case of all other
registrations hereunder, the Holders of a Majority in Interest of the
Registrable Shares participating in the registration), expenses of any audits
incident to or required by any such registration and expenses of complying with
the state securities or "blue sky" laws of any jurisdictions (all of such
expenses referred to as "Registration Expenses"), shall be paid by TWUS whether
or not the registration statement to which such Registration Expenses relate
becomes effective. Notwithstanding the foregoing, in the event of a registration
pursuant to the last sentence of Section 2(b), TWUS shall, in addition to its
other obligations hereunder, pay all fees and disbursements of counsel selected
by a Majority in Interest of the Investors (as defined in the Reorganization
Agreement) and counsel selected by a majority in interest of the Hyperion
Shares, Compensatory Shares, Triumph Shares and Paribas Shares intended to be
covered by such registration statement.

     6. INDEMNIFICATION.

         (a) TWUS shall indemnify and hold harmless each selling Holder of
Registrable Shares, and directors, officers, partners, shareholders, members,
employees and agents of any of them, and each Person who participates in the
offering of such securities and each Affiliate of such seller or participating
Person (individually and collectively, the "Indemnified Person") against any
losses, claims, damages or liabilities, including reasonable legal fees,
disbursements and expenses of counsel (including any such fees, disbursements
and expenses incurred as a result of a third party action or as a result of the
Indemnified Person enforcing its rights under this Section 6(a) against TWUS)
(collectively, "Liability"), joint or several, to which such Indemnified Person
may become subject under the Securities Act or any other statute or at common
law, insofar as the Liability (or action in respect thereof) arises out of, is
based upon or relates to (i) any untrue statement or alleged untrue statement of
any material fact contained, on the effective date thereof, in any Registration
Statement under which such securities were registered under the Securities Act,
any preliminary Prospectus or final Prospectus contained therein, or any
amendment or supplement thereto or any documents filed under state securities
laws or "blue sky" laws, (ii) any omission or alleged omission to state therein
a material fact required to be stated therein or necessary to make the
statements therein not misleading, or (iii) any violation or alleged violation
by TWUS of the Securities Act, any state securities or "blue sky" laws or any
sale or regulation thereunder in connection with such

                                       13
<PAGE>

registration. Except as otherwise provided in Section 6(c), TWUS shall reimburse
each such Indemnified Person for all reasonable legal and other expenses
incurred in connection with investigating or defending any Liability; provided,
however, that TWUS shall not be liable to any Indemnified Person in any such
case to the extent that the Liability arises out of, is based upon or relates to
any untrue statement or alleged untrue statement or omission or alleged omission
made in such Registration Statement, preliminary or final Prospectus, or
amendment or supplement thereto in reliance upon and in conformity with
information furnished in writing to TWUS by such Person specifically for use
therein; and provided further, that TWUS shall not be required to indemnify any
Person against Liability that arises out of the failure of any Person to deliver
a Prospectus as required by the Securities Act regardless of any investigation
made by or on behalf of such Indemnified Person and TWUS' indemnification
obligations shall survive transfer of such securities by such seller.

         (b) Each Holder of Registrable Shares holding any securities included
in such registration being effected shall indemnify and hold harmless each other
selling Holder of Registrable Shares (including to the extent applicable its
partners, members and shareholders (including partners of partners and
shareholders of such partners)), TWUS, and directors, officers, employees and
agents of each of them, and each Affiliate of such seller and directors,
officers, employees and agents of any of them (individually and collectively
also the "Indemnified Person"), against any liability, joint or several, to
which the Indemnified Person may become subject under the Securities Act or any
other statute or at common law, insofar as such liability (or actions in respect
thereof) arises out of or is based upon (i) any untrue statement or alleged
untrue statement of any material fact contained, on the effective date thereof,
in any Registration Statement under which securities were registered under the
Securities Act at the request of such selling Holder, any preliminary Prospectus
or final Prospectus contained therein, or any amendment or supplement thereto,
(ii) any omission or alleged omission by such selling Holder to state therein a
material fact required to be stated therein or necessary to make the statements
therein not misleading, or (iii) any violation or alleged violation by such
selling Holder of the Securities Act, any state securities or "blue sky" laws or
any sale or regulation thereunder in connection with such registration; in the
case of subclause (i) and (ii) to the extent, but only to the extent, that such
untrue statement or alleged untrue statement or omission or alleged omission was
made in such Registration Statement, preliminary or final Prospectus, amendment
or supplement thereto in reliance upon and in conformity with information
furnished in writing to TWUS by such selling Holder specifically for use
therein. The liability of any Holder for indemnification under this Section 6 in
its capacity as a seller of Registrable Shares shall not exceed the lesser of
(i) that proportion of the total of such losses, claims, damages, expenses or
liabilities indemnified against equal to the proportion of the total securities
sold under such Registration Statement held by such Holder, and (ii) the amount
equal to the net proceeds to such Holder of the securities sold in any such
registration; provided that no selling Holder shall be required to indemnify any
Person against any liability arising from any untrue or misleading statement or
omission contained in any preliminary Prospectus if such deficiency is corrected
in the final Prospectus or for any liability which arises out of the failure of
any Person to deliver a Prospectus as required by the Securities Act.

                                       14
<PAGE>

         (c) In the event TWUS, any selling Holder or other Person receives a
complaint, claim or other notice of any liability or action, giving rise to a
claim for indemnification under Sections 6(a) or (b) above, the Person claiming
indemnification under such paragraphs shall promptly notify the Person against
whom indemnification is sought (the "Indemnifying Person") of such complaint,
notice, claim or action, and the Indemnifying Person shall have the right to
investigate and defend any such loss, claim, damage, liability or action;
provided that the failure to promptly give notice shall not relieve the
Indemnifying Person from any Liability except to the extent that it is
materially prejudiced by the failure or delay of the Indemnified Person in
giving such notice. If any such complaint, claim or other notice of any
Liability or action is brought against any Indemnified Person and it notifies
the Indemnifying Person of its commencement, the Indemnifying Person will be
entitled to participate in and, to the extent that it elects by delivering
written notice to the Indemnified Person promptly after receiving notice of the
commencement of the action from the Indemnified Person, jointly with any other
Indemnifying Person similarly notified, to assume the defense of the action,
with counsel reasonably satisfactory to the Indemnified Person, and after notice
from the Indemnifying Person to the Indemnified Person of its election to assume
the defense, the Indemnifying Person shall not be liable to the Indemnified
Person for any legal or other expenses except as provided below and except for
the reasonable costs of investigation subsequently incurred by the Indemnified
Person in connection with the defense. The Indemnified Person shall have the
right to employ its own counsel in any such action, but the fees, expenses and
other charges of such counsel shall be at the expense of the Indemnified Person
unless (i) the employment of counsel by the Indemnified Person has been
authorized in writing by the Indemnifying Person, (ii) the Indemnified Person
has reasonably concluded (based on advice of counsel) that there may be legal
defenses available to it or other Indemnified Persons different from or in
addition to those available to the Indemnifying Person or Persons, (iii) a
conflict or potential conflict exists (based on advice of counsel to the
Indemnified Person) between the Indemnified Person and the Indemnifying Person
(in which case the Indemnifying Person shall not have the right to direct the
defense of such action on behalf of the Indemnified Person), or (iv) the
Indemnifying Person has not in fact employed counsel to assume the defense of
such action within a reasonable time after receiving notice of the commencement
of the action or has failed to employ counsel reasonably satisfactory to such
Indemnified Person, in each of which cases the reasonable fees, disbursements
and other charges of counsel will be at the expense of the Indemnifying Person
or Persons. The Indemnifying Person or Persons shall not, unless there exists a
conflict of interest among the Indemnified Persons, in connection with any
proceeding or related proceedings in the same jurisdiction, be liable for the
reasonable fees, disbursements and other charges of more than one separate firm
admitted to practice in such jurisdiction at any time for all such Indemnified
Persons. All such fees, disbursements and other charges shall be reimbursed by
the Indemnifying Person promptly as they are incurred. An Indemnifying Person
shall not be liable for any settlement of any action or claim effected without
its written consent (which consent will not be unreasonably withheld). No
Indemnifying Person shall, without the prior written consent of each Indemnified
Person, settle or compromise or consent to the entry of any judgment in any
pending or threatened claim, action or proceeding relating to the matters
contemplated by this Section 6 (whether or not any Indemnified Person is a party
thereto), unless such settlement, compromise or consent (i) includes an
unconditional release of each Indemnified Person from all liability arising or
that may arise out of such claim, action or proceeding, (ii) does not include a
statement as to or an admission of fault, culpability or a

                                       15
<PAGE>

failure to act by or on behalf of any Indemnified Person, and (iii) does not
commit the Indemnified Person to take, or to forbear to take, any action. If a
settlement is reached with such consent or if a final judgment is entered for
the plaintiff, the Indemnifying Person agrees to indemnify any Indemnified
Person from and against any loss or liability by reason of such settlement or
judgment.

         (d) If the indemnification provided for in this Section 6 for any
reason is held by a court of competent jurisdiction to be unavailable to an
Indemnified Person in respect of any losses, claims, damages expenses or
liabilities referred to therein, then each Indemnifying Person under this
Section 6, in lieu of indemnifying the Indemnified Person thereunder, shall
contribute to the amount paid or payable by the Indemnified Person as a result
of such losses, claims, damages, expenses or liabilities (i) in such proportion
as is appropriate to reflect the relative benefits received by TWUS and the
Holder or Holders of Registrable Shares from the offering of Registrable Shares
or (ii) if the allocation provided by clause (i) above is not permitted by
applicable law, in such proportion as is appropriate to reflect not only the
relative benefits referred to in clause (i) above but also the relative fault of
TWUS, the other Holders of Registrable Shares in connection with the statements
or omissions that resulted in such losses, claims, damages expenses or
liabilities, as well as any other relevant equitable considerations. The
relative benefits received by TWUS and the Holders of Registrable Shares shall
be deemed to be in the same respective proportions that the net proceeds from
the offering (before deducting expenses) received by TWUS and the Holders of
Registrable Shares, in each case as set forth in the table on the cover page of
the applicable prospectus, bear to the aggregate public offering price of the
Registrable Shares. The relative fault of TWUS and the Holders of Registrable
Shares shall be determined by reference to, among other things, whether the
untrue or alleged untrue statement of a material fact or the omission or alleged
omission to state a material fact relates to information supplied by TWUS or the
Holders of Registrable Shares, and the parties' relative intent, knowledge,
access to information and opportunity to correct or prevent such statement or
omission.

     TWUS and the Holders of Registrable Shares agree that it would not be just
and equitable if contribution pursuant to this Section 6(d) were determined by a
method of allocation that does not take account the equitable considerations
referred to in the immediately preceding paragraph, provided that a Holder of
Registrable Shares shall not be required to contribute under this Section 6(d)
in excess of the lesser of (i) that proportion of the total Liability
indemnified against equal to the proportion of the total Registrable Shares sold
under such Registration Statement by such Holder and (ii) the net proceeds
received by such Holder from its sale of Registrable Shares under such
Registration Statement. No Person found guilty of fraudulent representation
(within the meaning of Section 11(f) of the Securities Act) shall be entitled to
contribution from any person not found guilty of such fraudulent
misrepresentation.

         (e) The amount paid by an Indemnifying Person or payable to an
Indemnified Person as a result of the losses, claims, damages, expenses and
liabilities referred to in this Section 6 shall be deemed to include, subject to
limitations set forth above, any legal or other expenses reasonably incurred by
such Indemnified Person in connection with investigating or defending any such
action or claim, payable as the same are incurred. The indemnification and

                                       16
<PAGE>

contribution provided for in this Section 6 shall remain in full force and
effect regardless of any investigation made by or on behalf of the indemnified
parties or any other officer, director, employee, agent or controlling person of
the indemnified parties.

     7. COMPLIANCE WITH RULE 144. TWUS shall use its reasonable best efforts to
file with the Commission such information as is required under the Exchange Act
for so long as there are holders of Registrable Shares; and in such event, TWUS
shall use its reasonable best efforts to take all action as may be required as a
condition to the availability of Rule 144 under the Securities Act (or any
comparable successor rules). TWUS shall furnish to any holder of Registrable
Shares upon request a written statement executed by TWUS as to the steps it has
taken to comply with the current public information requirement of Rule 144 (or
such comparable successor rules). So long as there are holders of Registrable
Shares, TWUS shall furnish to any Holder upon request (i) a copy of the most
recent annual or quarterly report of TWUS and such other reports and documents
filed by TWUS with the Securities and Exchange Commission as are reasonably
requested and (ii) such information as may be reasonably requested in availing
any Holder of any rule or regulation of the Securities and Exchange Commission
which permits the selling or offering of any TWUS securities by such Holder.
TWUS shall use its reasonable best efforts to facilitate and expedite transfers
of Registrable Shares pursuant to Rule 144 under the Securities Act, which
efforts shall include timely notice to its transfer agent to expedite such
transfers of Registrable Shares.

     8. INTENTIONALLY OMITTED.

     9. AMENDMENTS. This Agreement may be amended, and TWUS may take any action
herein prohibited or omit to perform any act herein required to be performed by
it, only if TWUS has obtained the written consent of (i) a Majority in Interest
with respect to the rights of the Investors, (ii) Hyperion with respect to the
rights of Hyperion, (iii) Triumph with respect to the rights of Triumph, (iv)
each of the Employees with respect to the rights of such Employee or (v) Paribas
with respect to the rights of Paribas. For the purposes of this Agreement and
all agreements executed pursuant hereto, no course of dealing between or among
any of the parties hereto and no delay on the part of any party hereto in
exercising any rights hereunder or thereunder shall operate as a waiver of the
rights hereof and thereof.

     10. SUSPENSION OF REGISTRATION REQUIREMENT; RESTRICTION ON SALES.

         (a) TWUS shall promptly notify each Holder of, and confirm in writing,
(i) the receipt of any oral or written communication that could reasonably lead
TWUS to be unable to keep a Resale Registration Statement or Affiliate
Registration Statement continuously effective for the period set forth in
Section 2 hereof, or (ii) the issuance by the Commission of any stop order
suspending the effectiveness of a Registration Statement with respect to such
holder's Registrable Shares or the initiation of any proceedings for that
purpose. TWUS shall use its reasonable best efforts to obtain the withdrawal of
any order suspending the effectiveness

                                       17
<PAGE>

of such a Registration Statement at the earliest possible moment and in any
event within thirty (30) days from the initial date of such suspension.

         (b) Notwithstanding anything to the contrary set forth in this
Agreement, TWUS' obligations under this Agreement to file, amend or supplement a
Registration Statement, or to cause a Registration Statement, or any filings
with any state securities commission, to become effective shall be suspended,
for one or more periods not to exceed the period described in Section 11 below,
in the event of pending negotiations relating to, or consummation of, a
transaction or the occurrence of an event that (i) would require additional
disclosure of material information by the TWUS in the Registration Statement or
such filing, as to which TWUS has a bona fide business purpose for preserving
confidentiality, or (ii) render TWUS unable to comply with the Commission
requirements (any such circumstances being hereinafter referred to as a
"Suspension Event"). TWUS shall notify the Holders of the Shares of the
existence of any Suspension Event by promptly delivering to each Holder a
certificate signed by an executive officer of TWUS stating that a Suspension
Event has occurred and is continuing.

         (c) Subject to the terms of Section 11 below, so long as all officers
and directors of TWUS are bound by similar restrictions, each Holder of
Registrable Shares agrees, if requested by TWUS in the case of a TWUS-initiated
non-underwritten offering of TWUS Common Stock by TWUS registered under the
Securities Act or if requested by the managing underwriter or underwriters in a
TWUS-initiated underwritten offering of TWUS Common Stock by TWUS (each, a "TWUS
Offering"), not to directly or indirectly offer, sell, contract to sell, sell
any option or contract to purchase, purchase any option or contract to sell,
grant any option, right or warrant for the sale of or otherwise dispose of or
transfer any Shares held by it during the period (other than to donees or
partners who agree to be similarly bound) (the "Offering Blackout Period")
beginning upon receipt by such Holder of written notice from TWUS, but in any
event no earlier than the tenth (10th) day preceding the anticipated date of
pricing of such TWUS Offering, and ending on the earlier to occur of:

               (i)       sixty (60) days after the closing date of such TWUS
                         Offering; or

               (ii)      one (1) day after the date on which the Fair Market
                         Value of the TWUS Common Stock shall have averaged for
                         a period of twenty (20) consecutive trading days at
                         least one-hundred-five percent (105%) of the initial
                         price to the public of such security in such TWUS
                         Offering, but in any event not earlier than forty-five
                         (45) days after the closing date of such TWUS Offering;
                         or

               (iii)     the date on which TWUS may begin to effect any public
                         sale or distribution of any TWUS Common Stock following
                         such TWUS Offering pursuant to any contractual lock-up
                         or similar restrictions on the sale of such securities;
                         or

               (iv)      the date on which all directors and executive officers
                         who have been required to enter into contractual
                         lock-up or similar

                                       18
<PAGE>

                         restrictions on the sale of TWUS Common Stock owned by
                         them may begin to effect public sales of such shares
                         following such TWUS Offering, including pursuant to
                         waivers of the restrictions by the managing underwriter
                         or underwriters; or

               (v)       the date TWUS or managing underwriter or underwriters
                         withdraws such request in writing.

         (d) Subject to the terms of Section 11 below, each Holder of
Registrable Shares agrees that, following the effectiveness of any Registration
Statement relating to Registrable Shares of such Holder, such Holder will not
effect any sales of the Shares pursuant to such Registration Statement or any
filings with any state securities commission at any time after such Holder has
received notice from TWUS to suspend sales as a result of the occurrence or
existence of any Suspension Event or so that TWUS may correct or update the
Registration Statement or such filing. The Holders may recommence effecting
sales of the Shares pursuant to the Registration Statement or such filings, and
all other obligations which are suspended as a result of a Suspension Event
shall no longer be so suspended, following further notice to such effect from
TWUS, which notice shall be given by TWUS not later than one (1) business day
after the conclusion of any such Suspension Event.

     11. LIMITATIONS ON SUSPENSION/BLACKOUT PERIODS. Notwithstanding anything
herein to the contrary, TWUS covenants and agrees that (a) TWUS' rights to
suspend its obligation under this Agreement to file, amend or supplement a
Registration Statement and maintain the effectiveness of any Registration
Statement during the pendency of any Suspension Event, (b) the Holders'
obligation to suspend public sales of Shares during one or more Offering
Blackout Periods and (c) the Holders' obligations to suspend sales of Shares
pursuant to a Registration Statement during the pendency of any Suspension
Event, shall not (i) be exercised or triggered by TWUS pursuant to Section 10 or
otherwise more than two (2) times during any 12-month period or (ii) in the
aggregate, cause the Holders to be required to suspend sales of Shares or
relieve TWUS of its obligation to file, amend or supplement and maintain the
effectiveness of a Registration Statement for longer than ninety (90) days
during any 12-month period.

     12. TRANSFERABILITY OF REGISTRATION RIGHTS. The registration rights set
forth in this Agreement are transferable to each transferee of Registrable
Shares, who shall thereafter be deemed a "Holder" for purposes of this
Agreement. Each subsequent Holder of Registrable Shares must consent in writing
to be bound by the terms and conditions of this Agreement in order to acquire
the rights granted pursuant to this Agreement. This Agreement shall inure to the
benefit of and be binding on the successors and assigns of each of the parties
hereto. If any transferee of any Holder shall acquire Registrable Shares in any
manner, whether by operation of law or otherwise, such Registrable Shares shall
be held subject to all of the terms of this Agreement, and by taking and holding
such Registrable Shares such Person shall be conclusively deemed to have agreed
to be bound by and to perform all of the terms and provisions of this Agreement
and such Person shall be entitled to receive the benefits hereof.

                                       19
<PAGE>

     13. ATTORNEYS' FEES. If any action at law or in equity is necessary to
enforce or interpret the terms of this Agreement, the prevailing party shall be
entitled to reasonable attorney's fees, costs and necessary disbursements in
addition to any other relief to which such party may be entitled.

     14. DAMAGES. TWUS stipulates that each Holder of Registrable Shares shall
not have an adequate remedy if TWUS fails to comply with this Agreement and that
damages shall not be readily ascertainable, and accordingly, TWUS shall not
oppose an application by any Holder of Registrable Shares or any other Person
entitled to the benefits of this Agreement to require specific performance of
any and all provisions hereof or enjoining TWUS from continuing to commit any
such breach of this Agreement.

     15. MISCELLANEOUS.

         (a) Notices. Any notice or demand which is required or provided to be
given under this Agreement shall be deemed to have been sufficiently given and
received for all purposes when delivered in writing by hand, telecopy, telex or
other method of facsimile, or five (5) days after being sent by certified or
registered mail, postage and charges prepaid, return receipt requested, or two
(2) days after being sent by overnight delivery providing receipt of delivery,
to the following addresses:

     If to TWUS:

         Allied Healthcare International Inc.
         555 Madison Avenue
         New York, NY  10022
         Attention: Jack Wynne
         Telecopy No.: (212) 750-7221

     With a copy to:

         Brown Raysman Millstein Felder & Steiner LLP
         900 Third Avenue
         New York, NY  10022
         Attention: Leslie J. Levinson, Esq.
         Telecopy No.: (212) 895-2900

     If to the Investors or Triumph:

         Triumph Partners III, L.P.
         Triumph III Investors, L.P.
         28 State Street, 37th Floor
         Boston, MA  02109
         Attention: Frederick S. Moseley IV
         Telecopy No.: (617) 557-6014

                                       20
<PAGE>

     With a copy to:

         Goodwin Procter LLP
         Exchange Place
         53 State Street
         Boston, MA  02109
         Attention: Ettore A. Santucci, P.C.
         Telecopy No.:  (617) 523-1231

     If to Hyperion:

         Hyperion Partners II L.P.
         50 Charles Lindbergh Parkway
         Uniondale, NY  11553
         Attention: Scott Shay
         Telecopy No.: (516) 745-6787

     With a copy to:

         Proskauer Rose LLP
         1585 Broadway
         New York, NY  10036
         Attention: Bruce Lieb, Esq.
         Telecopy No.: (212) 969-3000

     If to the Employees:

         Allied Healthcare International Inc.
         555 Madison Avenue
         New York, NY  10022
         Attention: Timothy Aitken and Sarah Eames
         Telecopy No.: (212) 750-7221

     With a copy to:

         Brown Raysman Millstein Felder & Steiner LLP
         900 Third Avenue
         New York, NY  10022
         Attention: Leslie J. Levinson, Esq.
         Telecopy No.: (212) 895-2900

                                       21
<PAGE>

     If to Paribas:

         BNP Paribas
         10 Harewood Avenue
         London NW1 6AA
         United Kingdom
         Attention: Leo Leslie
         Telecopy No.: 44 20 7595 5596

     With a copy to the attention of Patrick Fox, at the same address

     If to any other Holder of Registrable Shares:

          at such Person's address for notice as set forth in the books and
records of TWUS or, as to each of the foregoing, at such other address as shall
be designated by such Person in a written notice to other parties complying as
to delivery with the terms of this subsection (a).

     16. GOVERNING LAW. This Agreement shall be deemed to be a contract made
under and shall be construed in accordance with the laws of the state of New
York, without giving effect to conflict of laws principles thereof.

     17. CHOICE OF LAW/CONSENT TO JURISDICTION. All disputes, claims or
controversies arising out of this Agreement, or the negotiation, validity or
performance of this Agreement shall be governed by and construed in accordance
with the laws of the State of New York without regard to its rules of conflict
of laws. Each of TWUS and the Holders hereby irrevocably and unconditionally
consents to submit to the sole and exclusive jurisdiction of the courts of the
State of New York and of the United States of America located in the State of
New York (the "New York Courts") for any litigation arising out of or relating
to this Agreement, or the negotiation, validity or performance of this Agreement
(and agrees not to commence any litigation relating thereto except in such
courts), waives any objection to the laying of venue of any such litigation in
the New York Courts and agrees not to plead or claim in any New York Court that
such litigation brought therein has been brought in any inconvenient forum. Each
of the parties hereto agrees, (a) to the extent such party is not otherwise
subject to service of process in the State of New York, to appoint and maintain
an agent in the State of New York as such party's agent for acceptance of legal
process, and (b) that service of process may also be made on such party by
prepaid certified mail with a proof of mailing receipt validated by the United
States Postal Service constituting evidence of valid service. Service made
pursuant to (a) or (b) above shall have the same legal force and effect as if
served upon such party personally within the State of New York. For purposes of
implementing the parties' agreement to appoint and maintain an agent for service
of process in the State of New York, each party shall appoint an agent that is
reasonably acceptable to the Holders and TWUS.

     18. COUNTERPARTS. This Agreement may be executed simultaneously in any
number of counterparts, each of which when so executed and delivered shall be
taken to be an original, but such counterparts shall together constitute but one
and the same document.

                                       22
<PAGE>

     19. SEVERABILITY. Whenever possible, each provision of this Agreement shall
be interpreted in such a manner as to be effective and valid under applicable
law, but if any provision of this Agreement shall be deemed prohibited or
invalid under such applicable law, such provision shall be ineffective to the
extent of such prohibition or invalidity, and such prohibition or invalidity
shall not invalidate the remainder of such provision or the other provisions of
this Agreement.

     20. INTEGRATION. This Agreement, including the exhibits, the Reorganization
Agreement and instruments referred to herein or therein, constitutes the entire
agreement, and supersedes all other prior agreements and understandings, both
written and oral, among the parties with respect to the subject matter hereof.

                                       23
<PAGE>

     IN WITNESS WHEREOF, the parties hereto have caused this Registration Rights
Agreement to be duly executed as of the date first set forth above.

                                        TWUS:
                                        -----

                                        ALLIED HEALTHCARE INTERNATIONAL INC.
                                        (F/K/A TRANSWORLD HEALTHCARE, INC.)

                                        By: /s/ John B. Wynne
                                            ------------------------------------
                                        Name:
                                             -----------------------------------
                                        Title:
                                              ----------------------------------

                                      S-1
<PAGE>

                                   HOLDERS:

                                   TRIUMPH PARTNERS III, L.P.

                                   By: Triumph III Advisors, L.P., its general
                                       partner

                                   By: /s/ Frederick S. Moseley, IV
                                       -----------------------------------------
                                   Name:  Frederick S. Moseley, IV
                                   Title: President

                                   TRIUMPH III INVESTORS, L.P.

                                   By: Triumph III Investors, Inc., its general
                                       partner

                                   By: /s/ Frederick S. Moseley, IV
                                       -----------------------------------------
                                   Name:  Frederick S. Moseley, IV
                                   Title: President

                                      S-2
<PAGE>

                                        HYPERION PARTNERS II L.P.
                                        By:   Hyperion Ventures II L.P.
                                              its general partner
                                        By:   Hyperion Funding II Corp.
                                              its general partner

                                        By: /s/ Scott A. Shay
                                            ------------------------------------
                                            Name:  Scott A. Shay
                                            Title: Executive Vice President

                                        HYPERION TW FUND L.P.

                                        By:   Hyperion TW LLC
                                              its general partner
                                        By:   Hyperion Partners II L.P.,
                                              its managing member
                                        By:   Hyperion Ventures II L.P.,
                                              its general partner
                                        By:   Hyperion Funding II Corp.,
                                              its general partner

                                        By: /s/ Scott A. Shay
                                            ------------------------------------
                                        Name:  Scott A. Shay
                                        Title: Executive Vice President

                                        HYPERION TWH FUND LLC

                                        By: /s/ Scott A. Shay
                                            ------------------------------------
                                        Name:  Scott A. Shay
                                        Title: Managing Member

                                        HYPERION TWH FUND II LLC

                                        By: /s/ Scott A. Shay
                                            ------------------------------------
                                        Name:  Scott A. Shay
                                        Title: Managing Member

                                      S-3
<PAGE>

                                            ORDINARY SHAREHOLDERS:
                                            ----------------------

                                            /s/ Charles Murphy
                                            ------------------------------------
                                            Wendy Anne Thompson, by her duly
                                            authorized Attorney

                                            /s/ Charles Murphy
                                            ------------------------------------
                                            Belinda Burgess , by her duly
                                            authorized Attorney

                                      S-4
<PAGE>

                            REDEEMABLE SHAREHOLDERS:
                            ------------------------

<TABLE>
<CAPTION>

<S>                                                  <C>
MLS INVESTMENTS LIMITED, by its duly                 RICHARD GREEN and SARAH GREEN,
authorized Attorney                                  JOINTLY

By: /s/ Charles Murphy                               By: /s/ Charles Murphy
    ---------------------------------------              -------------------------------------------
Name:  Charles Murphy                                Richard Green, by his duly authorized Attorney
Title: Group Finance Director
                                                     By: /s/ Charles Murphy
                                                         -------------------------------------------
                                                     Sarah Green, by her duly authorized Attorney

/s/ Charles Murphy                                   /s/ Charles Murphy
---------------------------------------              -----------------------------------------------
David Johnson, by his duly authorized                Dominic Rothwell, by his duly authorized
Attorney                                             Attorney

/s/ Charles Murphy                                   /s/ Charles Murphy
---------------------------------------              -----------------------------------------------
Charles Murphy                                       Stuart Reynolds, by his duly authorized
                                                     Attorney

/s/ Charles Murphy                                   /s/ Charles Murphy
---------------------------------------              -----------------------------------------------
Steven Gullick, by his duly authorized               Jan Baum, by his duly authorized
Attorney                                             Attorney

/s/ Charles Murphy                                   /s/ Charles Murphy
---------------------------------------              -----------------------------------------------
Tracey Dale, by her duly authorized                  Chris Powell, by his duly authorized Attorney
 Attorney

/s/ Charles Murphy                                   /s/ Charles Murphy
---------------------------------------              -----------------------------------------------
Kirsten Parton, by her duly authorized               Mandy Medcraft, by her duly authorized Attorney
Attorney

/s/ Charles Murphy                                   /s/ Charles Murphy
---------------------------------------              -----------------------------------------------
Tim Faun, by his duly authorized                     John Menniss, by his duly authorized Attorney
Attorney

/s/ Charles Murphy                                   /s/ Charles Murphy
---------------------------------------              -----------------------------------------------
Jeremy Fry, by his duly authorized                   Jayne Bunn, by her duly authorized Attorney
Attorney

/s/ Charles Murphy                                   /s/ Charles Murphy
---------------------------------------              -----------------------------------------------
Kevin Taylor, by his duly authorized                 Linos Walters, by his duly authorized Attorney
Attorney
</TABLE>

                                      S-5
<PAGE>

<TABLE>
<CAPTION>

<S>                                                    <C>
/s/ Charles Murphy                                     /s/ Charles Murphy
----------------------------------------               ----------------------------------------
Christin Brown, by her duly authorized                 Sylvia Withers, by her duly authorized
Attorney                                               Attorney

/s/ Charles Murphy                                     /s/ Charles Murphy
----------------------------------------               ----------------------------------------
Joanne Ayre, by her duly authorized                    Norma Balls, by her duly authorized
Attorney                                               Attorney

/s/ Charles Murphy                                     /s/ Charles Murphy
----------------------------------------               ----------------------------------------
Cecelia Lowe, by her duly authorized                   Lin Carter, by his duly authorized
Attorney                                               Attorney

/s/ Charles Murphy                                     /s/ Charles Murphy
----------------------------------------               ----------------------------------------
Angela Roberts, by her duly authorized                 Olive Bell, by her duly authorized
Attorney                                               Attorney

/s/ Charles Murphy                                     /s/ Charles Murphy
----------------------------------------               ----------------------------------------
Jane Swift, by her duly authorized                     Trudi Brett, by her duly authorized
Attorney                                               Attorney

/s/ Charles Murphy                                     /s/ Charles Murphy
----------------------------------------               ----------------------------------------
Gillian Bennett Newens, by her duly                    Yvonne Bishton, by her duly authorized
authorized Attorney                                    Attorney

/s/ Charles Murphy                                     /s/ Charles Murphy
----------------------------------------               ----------------------------------------
Melanie Combe, by her duly authorized                  Carol Williamson, by her duly authorized
Attorney                                               Attorney

/s/ Charles Murphy                                     /s/ Charles Murphy
----------------------------------------               ----------------------------------------
Maureen Parkinson, by her duly authorized              Angela Collacott, by her duly authorized
Attorney                                               Attorney

                                                       /s/ Charles Murphy
                                                       ----------------------------------------
                                                       Marianne Smith, by her duly authorized
                                                       Attorney

</TABLE>

                                      S-6
<PAGE>

/s/ Charles Murphy
----------------------------------------
Fiona Key, by her duly authorized
Attorney

                                      S-7
<PAGE>

                                 EQUITY WARRANT HOLDERS:

                                 TRIUMPH PARTNERS III, L.P.

                                 By: Triumph III Advisors, L.P., its general
                                     partner

                                 By: /s/ Frederick S. Moseley, IV
                                     -------------------------------------------
                                 Name:  Frederick S. Moseley, IV
                                 Title: President

                                 TRIUMPH III INVESTORS, L.P.

                                 By: Triumph III Investors, Inc., its general
                                     partner

                                 By: /s/ Frederick S. Moseley, IV
                                     -------------------------------------------
                                 Name:  Frederick S. Moseley, IV
                                 Title: President

                                 BNP PARIBAS

                                 By: /s/ Leo Leslie       /s/ Don Ercole
                                     -------------------------------------------
                                 Name:   Leo Leslie           Don Ercole
                                      ------------------------------------------
                                 Title:
                                       -----------------------------------------

                                 AITKEN (ENGLISH) COMPANY LIMITED

                                 By: /s/ Tim Aitken
                                     -------------------------------------------
                                 Name:
                                      ------------------------------------------
                                 Title:
                                       -----------------------------------------

                                      S-8
<PAGE>

                                    /s/ Tim Aitken
                                    --------------------------------------------
                                    Timothy M. Aitken

                                    /s/ Sarah L. Eames
                                    --------------------------------------------
                                    Sarah L. Eames

                                    /s/ Charles Murphy
                                    --------------------------------------------
                                    Charles Kernahan, by his duly authorized
                                    Attorney

                                    /s/ Charles Murphy
                                    --------------------------------------------
                                    David Johnson, by his duly authorized
                                    Attorney

                                    /s/ Charles Murphy
                                    --------------------------------------------
                                    Charles Murphy

                                    /s/ Charles Murphy
                                    --------------------------------------------
                                    Wayne Palladino, by his duly authorized
                                    Attorney

                                    /s/ Charles Murphy
                                    --------------------------------------------
                                    Steven Gullick, by his duly authorized
                                    Attorney

                                      S-9
<PAGE>

                                   ZRH Nominees (0051) Limited, acting by its
                                   duly authorized Attorney

                                   By: /s/ Charles Murphy
                                       -----------------------------------------
                                   Name:  Charles Murphy
                                   Title: Group Finance Director

                                   Orion Nominees Limited, acting by its duly
                                   authorized Attorney

                                   By: /s/ Charles Murphy
                                       -----------------------------------------
                                   Name:  Charles Murphy
                                   Title: Group Finance Director

                                   THE EMPLOYEES:
                                   --------------

                                   /s/ Tim Aitken
                                   ---------------------------------------------
                                   Timothy M. Aitken

                                   /s/ Sarah L. Eames
                                   ---------------------------------------------
                                   Sarah L. Eames

                                   BNP PARIBAS
                                   -----------

                                   By: /s/ Leo Leslie     /s/ Don Ercole
                                       -----------------------------------------
                                   Name:   Leo Leslie         Don Ercole
                                        ----------------------------------------
                                   Title:
                                         ---------------------------------------

                                      S-10
<PAGE>

                                  MEZZANINE WARRANT HOLDERS:
                                  --------------------------

                                  BNP PARIBAS

                                  By: /s/ Leo Leslie     /s/ Don Ercole
                                      ------------------------------------------
                                  Name:   Leo Leslie     Don Ercole
                                       -----------------------------------------
                                  Title:
                                        ----------------------------------------

                                  BAYERISCHE HYPO-UND
                                  VEIRENSBANK AG

                                  By: /s/ Ray Daws       /s/ Guy Beeston
                                      ------------------------------------------
                                  Name:   Ray Daws           Guy Beeston
                                       -----------------------------------------
                                  Title:  VP                 VP
                                        ----------------------------------------

                                  NMB HELLER

                                  By: /s/ J.P. Onslow
                                      ----------------------------------------
                                      Name:  J.P. Onslow
                                      Title: Director

                                      S-11
<PAGE>

                                    EXHIBIT A

                              ORDINARY SHAREHOLDERS
                              ---------------------

Wendy Anne Thompson
Belinda Burgess

<PAGE>

                                    EXHIBIT B

                             REDEEMABLE SHAREHOLDERS
                             -----------------------

MLS Investments Limited
Richard Green and Sarah Green (jointly)
David Johnson
Charles Murphy
Steven Gullick
Tracey Dale
Kirsten Parton
Tim Faun
Jeremy Fry
Kevin Taylor
Dominic Rothwell
Stuart Reynolds
Jan Baum
Chris Powell
Mandy Medcraft
John Menniss
Jayne Bunn
Linos Walters
Gillian Sadler
Christin Brown
Joanne Ayre
Cecelia Lowe
Angela Roberts
Jane Swift
Gillian Bennett Newens
Melanie Combe
Maureen Parkinson
Fiona Key
Sylvia Withers
Norma Balls
Lin Carter
Olive Bell
Trudi Brett
Yvonne Bishton
Carol Williamson
Angela Collacott
Marianne Smith

<PAGE>

                                    EXHIBIT C

                             EQUITY WARRANT HOLDERS
                             ----------------------

Triumph Partners III, L.P.
Triumph III Investors, L.P.
BNP Paribas
Aitken (English) Company Limited
Timothy M. Aitken
ZRH Nominees (0051) Limted
Sarah L. Eames
Orion Nominees Limited
Charles Kernahan
David Johnson
Charles Murphy
Wayne Palladino
Steven Gullick

<PAGE>

                                    EXHIBIT D
                                    ---------

                            MEZZANINE WARRANT HOLDERS
                            -------------------------

BNP Paribas
Bayerische Hypo-Und Veirensbank AG
NMB Heller

Source: [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00041-of-00352.parquet"}, [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00041-of-00352.parquet"}]]