Rajiv Gandhi University of Health Sciences, Karnataka,

Bangalore.

PROFORMA SYNOPSIS FOR REGISTRATION OF SUBJECT FOR DISSERTATION

DISSERTATION PROPOSAL

“A STUDY TO EVALUATE THE EFFECTIVENESS OF SELF INSTRUCTIONAL MODULE REGARDING THE

INFLUENCE OF PET THERAPY IN THE MANAGEMENT OF SELECTED PSYCHOLOGICAL PROBLEMS

AMONG ELDERLY CITIZENS RESIDING AT SELECTED RURAL AREA IN BANGALORE”.

SUBMITTED BY,

Ms. ASHA GEORGE.

1ST YEAR M.Sc NURSING,

BHAGATH COLLEGE OF NURSING,

#60, UTTARAHALLI MAIN ROAD,

UTTARAHALLI HOBLI,

BANGALORE- 560061.

1

Rajiv Gandhi University of Health Sciences, Karnataka, Bangalore.

PROFORMA SYNOPSIS FOR REGISTRATION OF SUBJECT FOR DISSERTATION

1 Name of the Candidate and Address Ms. ASHA GEORGE,

1ST YEAR M.Sc NURSING,

BHAGATH COLLEGE OF NURSING,

#60, UTTARAHALLI MAIN ROAD,

UTTARAHALLI HOBLI, BANGALORE: 560061.

2 Name of the Institution Bhagath College of Nursing.

3 Course of study and subject 1ST Year M.Sc Nursing,Psychiatric Nursing.

4 Date of admission to Course 01/06/2012

5 Title of the Topic“A Study To Evaluate The Effectiveness Of Self Instructional Module Regarding The Influence Of Pet Therapy In The Management Of Selected Psychological Problems Among Elderly Citizens Residing At Selected Rural Area In Bangalore.”

6 Brief resume of the intended work:6:1 Need for the study6:2 Review of literature6:3 Objectives of the study6:4 Operational definitions 6:5 Hypothesis of the study6:6 Assumptions6:7 Delimitations of the study6:8 Pilot study6:9 Variables

EnclosedEnclosedEnclosedEnclosedEnclosedEnclosedEnclosedEnclosedEnclosed

7Materials and Methods7:1 Source of data- Data will be collected from the Elderly citizens Residing at selected rural area in Bangalore.7:2 Method of collection of data: Structured knowledge questionnaire.7:3 Does the study require any investigation or interventions?Yes.7:4 Has ethical clearance been obtained from our institutions? Yes, Ethical committee’s report is here with enclosed.

8 List of references Enclosed

2

Rajiv Gandhi University of Health Sciences, Karnataka, Bangalore.

PROFORMA SYNOPSIS FOR REGISTRATION OF SUBJECT FOR DISSERTATION

1 Name of the Candidate and Address Ms. ASHA GEORGE,

1ST YEAR M.Sc NURSING,

BHAGATH COLLEGE OF NURSING,

#60, UTTARAHALLI MAIN ROAD,

UTTARAHALLI HOBLI, BANGALORE: 560061.

2 Name of the Institution Bhagath College of Nursing.

3 Course of Study and Subject 1st Year M.Sc Nursing,

Psychiatric Nursing.

4 Date of Admission to Course 01/06/2012

5 Title of the Topic

“A Study To Evaluate The Effectiveness Of Self Instructional Module Regarding The Influence Of

Pet Therapy In The Management Of Selected Psychological Problems Among Elderly Citizens

Residing At Selected Rural Area In Bangalore.”

6. BRIEF RESUME OF THE INTENDED WORK

3

INTRODUCTION

“It is the intuitive power of animals that can help us heal hurts, lessen stress, feel needed, and express our caring side.”

-Marty Becker, DVM

Pet therapy is a popular method of mild therapy for seniors. The documented benefits of interaction with

animals are physical, mental, and emotional. Animal therapy variations can differ depending upon the needs of the

seniors. While ownership therapy, where a senior living at home has a pet in the house, is the most effective type, it

is only an option for seniors in good health who are able to take care of the animal themselves1.

Animal-Assisted Therapy is a type of therapy that involves animals as a form of treatment. The goal of AAT

is to improve a patient’s social, emotional, or cognitive functioning. Advocates state that animals can be useful for

educational and motivational effectiveness for participants. A therapist who brings along a pet may be viewed as

being less threatening, increasing the rapport between patient and therapist. Animals used in therapy include

domesticated pets, farm animals and marine mammals. While the research literature presents the relationship

between humans and companion animals as generally favorable, methodological concerns about the poor quality of

the data have led to calls for improved experimental studies2.

The benefits of an animal-human bond have been documented for centuries. The relationship between a

therapy animal and a patient, however, extends far deeper than simple companionship; there are physical,

emotional, and mental benefits to this type of treatment.

The physical health benefits of animal therapy depend on which type of therapy is practiced and include the

following:

Increased mobility from brushing, petting, and walking an animal

Enhancing physical skills through intensive therapy such as riding horses or swimming with dolphins

Increased exercise if the pet's exercise needs are considerable

Lowered blood pressure and reduced stress from the gentle nature of the non-judgmental relationship

Emotionally, animals can provide seniors with companionship, as well as the following:

A sense of caring and gentleness as many animals instinctively nurture ailing humans

Increased self esteem as seniors find they can care for the pet or the animal enjoys seeing them

Decreased anxiety and depression by forming a nurturing bond with an animal

4

Reduced loneliness by caring for and spending time with an animal

Increased social interaction with other patients or animal handlers

Higher comfort levels when visiting with family members in the presence of the pet

Animal therapy even provides mental benefits to patients, including the following:

Memory stimulation by comparing the therapy animal to other pets

Planning and flexibility practice from planning care, but having the flexibility to respond to another living

creature's needs as they arise

Mental stimulation through contact with animal handlers or animal entertainment3

Animals fill a void in the lives of the elderly who are alone without friends or loved ones. Pets can greatly

increase quality of life for many senior citizens. Pets for the Elderly Foundation match seniors with cats and dogs

by underwriting the pets’ adoptions. “Those who are responsible for a pet are likely to take better care of

themselves, because they feel someone is counting on them,” said general manager Susan Kurowski. The Waltham

Book of Human-Animal Interactions published a study of elderly dog owners revealing 75 percent of men and 67

percent of women considered their dog their only friend.

While Pets for the Elderly focuses on matching senior citizens with cats and dogs, birds, rabbits, and fish still

provide the desired influences. The Waltham Book of Human-Animal Interactions also published a study that found

elderly women in nursing homes preferred an hour-long session interacting with a rabbit to an hour of open leisure

time. Animals don’t judge the people who love them, making the comfort of a lap animal, the liveliness of an

aviary, or an aquarium’s tranquility unconditional pleasures.

Policies that encourage pet ownership among the aged, either at home or as they make the transition to elder

living facilities, can improve some medical conditions and alleviate loneliness. For people who enjoy animals,

though, pet therapy offers some solid benefits: better health, more relaxed mood, enhanced connection to the world,

improved communication, and the badly needed chance to play and create. Be it on a doctor’s chart or in the

wordless testimony of the animal itself, creatures of all kinds strengthen the lives they touch4.

6.1 NEED FOR THE STUDY

5

“It is only with the heart that one can see rightly, what is essential is invisible to the eye.”

- Little Prince

We had an elderly gentleman adopt a puppy today,” Michelle McCann of participant PAWS in Ft. Walton

Beach, Fla., wrote to Pets for the Elderly. “He was standing in the lobby holding his puppy as we all 'oohed' and

'ahhed,' and he was laughing about what a chick magnet his puppy was going to be!”

Animals are indeed social magnets. Nursing home communities such as Silverado and Eden Alternative

were founded on principles of meaningful interactions driven by an animal-filled environment. Administrator

Noralynn Snow houses dogs, cats, birds, fish — even kangaroos — at Silverado’s Aspen Park facility. The latter

especially, she says, has the “ooh, ahh” factor, which encourages families normally shy of the residents at the home,

to visit. Cooperative animal care also spurs interaction between the residents5.

Not every animal is appropriate for pet therapy work. The ideal therapy pet is calm and gentle with no

aggressive tendencies. This is especially important for therapy pets who work with people with dementia. Like a

small child, a person with advanced dementia may not know how to respond appropriately to a pet and may

accidentally startle it or pull at its fur. The animal's tendency should be to withdraw rather than to attack.

Research has shown how beneficial pet therapy can be to the elderly, especially those who are living in a

nursing home. Regular visits with pets, usually dogs, can have positive physical, emotional, and mental benefits.

Physical benefits include lowering blood pressure, lowering heart rate, and reducing overall stress. Emotional

benefits are reducing anxiety and depression, decreasing loneliness through increasing social interaction with the

pets and their human companions. Consistent interaction with a pet has been shown to cause an increased release of

serotonin and dopamine in the brain which can help calm and soothe a person’s body. This can be helpful for

patients with Alzheimer’s dementia, as regular pet visits may help to decrease unwanted behaviors and calm their

agitation. Also there are mental benefits that are a result of increased mental stimulation, whether it’s talking to the

pet directly, asking questions to the dog’s owner or talking with other residents about the dog. All of these things

help to keep the brain active.

The study was conducted to evaluate the influences of pet therapy on cognitive function, mood and

perceived quality of life on elderly inpatients affected by dementia, depression and psychosis. The result shows that

the Both the pet group and control group improved on GDS and MMSE. Within the pet group, GDS symptoms

decreased by 50% (from 5.9 to 2.7, P= 0.013), whereas mean MMSE score increased by 4.5 (P= 0.060). The

between group comparison showed a positive influence of pet therapy intervention on GDS (P= 0.070). Most of the

participants reported an improvement of their perceived quality of life. Thus the study was concluded that the Pet

6

therapy is efficient in improving depressive symptoms and cognitive function in residents of long-term care

facilities with mental illness6.

The study aims at knowing old age problems especially for those living at elderly homes and extending

counseling services to the vast and new field of geriatrics in Iran. In this study 120 old people who lived at

governmental and private elderly homes in Tehran, Iran were randomly enrolled and studied using SCL90 and Beck

Depression Inventory. The results showed that signs of depression and somatization disorders were the most

common ones among the elderly in elderly homes. In all studied clinical scales, the rate of psychological symptoms

was more among women than men. Since living at an elderly home means staying away from family support and

that it is considered reproachable, attending to psychological and emotional needs of the elderly home residents is

essential7.

Researcher had a personal experience with neighbor’s elderly citizen who was suffering from loneliness. On

observation the researcher identified that there was lack of care by the family members. Gradually the elderly

citizen developed depression. From this experience, the researcher thought of taking the task of assessing the

knowledge of elderly citizens regarding pet therapy in the management of psychological problems and providing

them a self-instructional module.

6.2 REVIEW OF LITERATURE

7

Review of literature provides basis for future investigation, justifies the need for replication,

throws light up on feasibility of the study and indicates constraints of data collection and help to relate findings of

one another. The scope of literature review should be broad enough to allow the reader to become familiar with the

research problems and narrow enough to include predominantly relevant sources.

A study on coronary heart disease patients published in 1980 suggested that pet owners lived longer than

people who did not own pets. The researchers believed this occurred because owning an animal demands a lot of

work and a regular routine. The sense of responsibility was thought beneficial for individuals who are retired and

did not have any kind of scheduled activity for the day. Furthermore, pets can provide full love and attention

unconditionally, unlike humans that often bring negative emotions to a relationship. Humans also demand speech in

interactions, while communication with pets can often occur without a spoken word. Finally, maintaining one’s

attention on a fish or an animal playing can have a relaxing influence in the same way as holding attention in

meditation. Overall, there is a sense of companionship and stress-relief in pet ownership8.

Marcus et al. conducted a study using therapy dogs in an Outpatient Pain management clinic. Patients sat in

either a waiting room, or a room with a therapy dog in it. Results demonstrated that there were significant

improvements on pain, mood, and other distressful measures when patients or family members were placed in the

therapy dog room. The study took place over a 2 month time period. They concluded that patients visited by these

therapy dogs have a reduction in their pain rating and an improvement in their mood, with this in mind, there have

been many nursing homes and hospitals that elicit the help of cats and dogs as a comfort for patients in their time of

need9.

The study was conducted on psychological problems in the elderly .Intellectual changes in healthy old

people are slight and not of practical significance. When intellectual changes are suspected, patients should be

examined very carefully in a relaxed situation so they do not feel they are being `tested'. The physician should be

aware of the differential diagnosis of psychiatric disorders in the elderly and not simply label patients as `senile'.

The elderly are subject to acute brain syndromes caused by physical illness or drug toxicity. When acute brain

syndromes are excluded, the illness is as likely to be a functional one as a chronic organic brain syndrome. The

most common functional illness in old age is depression. More accurate diagnosis of elderly, mentally ill patients

will lead to more influenceive treatment and management10.

A survey of case histories, anecdotal evidence and pilot studies shows that, as therapeutic adjuncts, pet

animals facilitate rapport and enrich the treatment milieu. Pets enhance the lives of their owners in the community.

8

Pet-facilitated psychotherapy can increase social interaction, provide comfort, and reinforce feelings of

independence11.

The observational study was conducted on pet ownership may be a factor in improved health of the elderly.

The familiar adage "pets are good for your health" is an interesting but largely untested theory. A new model was

developed, based on pet ownership leads to better self care, to show possible associations between pet ownership

with eating, exercise, nutritional status, and specific cardiovascular risk factors. Statistical analyses of

questionnaire, anthropometric, physiological, and biochemical data were performed. Dog owners walked

significantly longer than non-owners (p < 0.05), and pet owners had significantly lower serum triglycerides than

non-owners (p < 0.01) 12.

The study was conducted among elderly women in two New Zealand cities; one allowed pet cats, one did

not. Attitudes toward pet cats were more positive in city allowing pets and among pensioners who owned, or

wished to own, cats. Since positive attitudes outweighed negative ones, City Authority banning cats reversed its

policy. Found conflicting evidence about cats' role in reducing loneliness13.

A 1-yr longitudinal study was conducted with standardized telephone interview data collected at baseline

and 1-yr later with 995 non institutionalized 65-80+ yr olds. Data were collected on social network activity, the

current number of selected health problems, pet ownership status, physical health (assessed as the ability to perform

Activities of Daily Living [ADLs]), psychological health, and socio demographic variables. Results show that pet

owners were younger, married or living with someone, and more physically active than non-pet owners. The ADL

level of non owners deteriorated more on average than that of pet owners during the 1-yr period. Ownership

significantly modified the relationship between social support and the change in psychological well-being over the

1-yr period14.

Examined two issues of pet ownership in mail questionnaire and interview survey of 1,595 older adults

over age 60, 377 of whom had a pet. Found evidence that pets were important determinant of housing choice. Many

elderly pet owners had made no arrangements for pet if they predecease it or become unable to care for it15.

The study was conducted on influences of pet therapy and pet therapy as psychotherapy. The human/animal

relationship exhibited by the elderly and their pets has limitations as well as potentials. The functions of a pet as a

companion and social facilitator in pet-facilitated psychotherapy include serving as a cotherapist for facilitation of

rapport, providing companionship, substituting for close interpersonal relationships (ie, significant others),

enhancing the health status of a variety of target groups, increasing opportunity for sensory stimulation, and

9

providing emotional support and a sense of well-being. Available information was limited because few studies have

been replicated, data were not validated, and previous studies were restricted mainly to institutionalized or

therapeutic environments16.

The therapeutic influences of human-animal relationships can be related to changes in physical health as

well. A 1988 study, conducted by Julia K. Vormbrock and John M. Grossberg, reviewed the physiological

influences of petting and talking to dogs. The patients were first selected for positive or neutral opinions of dogs.

The researchers discovered that blood pressure was lowest while petting the dogs, slightly higher when talking to

the dogs, and highest when speaking with the experimenter. The researchers believed that this finding might be

helpful for individuals with hypertension17.

6.3 OBJECTIVES OF THE STUDY

1. To assess the knowledge of Elderly citizens regarding the influence of Pet therapy in the management of

selected psychological problems.

2. To develop and administer a Self-Instructional Module regarding the influence of pet therapy in the

management of selected psychological problems among Elderly citizens.

3. To evaluate the effectiveness of Self Instructional Module among Elderly citizens regarding the influence of

Pet therapy in the management of selected psychological problems by posttest.

4. To find out the association between knowledge level of Elderly citizens regarding the influence of Pet

therapy for reducing psychological problems and their selected demographic variables.

6.4 OPERATIONAL DEFINITIONS

1. Evaluate: Evaluate refers to the critical analysis and evaluation or judgment of intellectual ability to answer for

the questions regarding the influence of pet therapy in the management of selected psychological problems among

elderly citizens.

2. Effectiveness: Effectiveness is a measure of Self-instructional module on influence of pet therapy in the

management of selected psychological problems among elderly citizens.

10

3. Self-Instructional Module: It refers to self-contained instructional module with details of influence of Pet

therapy in the management of selected psychological problems among elderly citizens.

4.Pet therapy:. It refers to the therapy that involves pet animals as a form of treatment in treating selected

psychological problems among elderly citizens.

5.Psychological problem: It refers to the problem that involves and affects the mind and caused by thoughts and

feelings of a individual person.

6. Elderly citizen: This refers to the citizens those who are more than 60 years of age.

6.5 HYPOTHESIS OF THE STUDY

H1: There will be statistically significant difference between pre and posttest knowledge scores of Elderly citizens

regarding influence of Pet therapy in the management of selected psychological problems.

H2: There will be statistically significant association between Elderly citizens knowledge regarding the influence of

Pet therapy in the management of selected psychological problems and their selected demographic variables.

6.6 ASSUMPTIONS:

1. Elderly citizens may have inadequate knowledge regarding the influence of Pet therapy in the management of

selected psychological problems.

2. Elderly citizens knowledge regarding the influence of pet therapy in the management of selected psychological

problems can be measured by using a structured knowledge questionnaire.

3. Elderly citizens knowledge regarding the influence of pet therapy in the management of selected psychological

problems can be improved by self-instructional module.

6.7 DELIMITATIONS OF THE STUDY

1. The study is limited only to Elderly citizens who are more than the age of 60Yrs.

2. The study is limited only to Elderly citizens who are residing at selected rural area, Bangalore city.

3. The study is limited only to Elderly citizens who are able to read and write Kannada or English.

6.8 PILOT STUDY:

11

The study will be conducted with 6 samples. The purpose to conduct pilot study is to find out the

feasibility for conducting the study and design on plan of statistical analysis.

6.9 VARIABLES:

Variables are qualities, properties or characteristics of persons, things or situations that change or vary

and are manipulated or measured in research.

Dependent variables: Knowledge level of Elderly citizens regarding the influence of pet therapy in the

management of selected psychological problems.

Independent variables: Self Instructional Module

Extraneous variable: Age, gender, educational status, occupational status, per capita monthly income of

the family, sources of information regarding pet therapy.

7 MATERIAL AND METHODS:

7.1 SOURCE OF DATA:

The data will be collected from all Elderly citizens who are residing at Selected urban area, Bangalore.

7.1.1 RESEARCH DESIGN

The research design adopted for this study is Pre experimental in nature. One group pretest- posttest

design.

7.1.2 RESEARCH APPROACH:

Evaluative research approach

7.1.3 SETTING OF THE STUDY:

The study will be conducted at selected rural area, Bangalore city.

7.1.4 POPULATION:

All the Elderly citizens who meet all the inclusion criteria and are residing in selected rural area Bangalore.

7.2 METHODS OF COLLECTION OF DATA (INCLUDING SAMPLING PROCEDURE):

12

The data collection procedure will be carried out for a period of one month. The study will be conducted

after obtaining permission from the concerned authorities. The investigator collects data from Elderly citizens by

using a structured knowledge questionnaire regarding the influence of Pet therapy in the management of selected

psychological problems.

The data collection instrument consists of following sections

Section A: Demographic Data

Section B: Questions related to the knowledge of Elderly citizens regarding the influence of Pet therapy in the

management of selected psychological problems.

7.2.1 SAMPLING TECHNIQUE:

Non-probability convenience sampling will be used to select the Elderly citizens who are residing at selected

rural area, Bangalore city.

7.2.2 SAMPLE SIZE:

Sample consists of 60 Elderly citizens who are residing at selected rural area, Bangalore city.

SAMPLING CRITERIA:

7.2.3 INCLUSION CRITERIA:

1. Elderly citizens who are residing at selected rural area, Bangalore city.

2. Elderly citizens who are at the age more than 60Years of age.

3. Elderly citizens who are available at the time of study.

4. Elderly citizens who are able to read and write Kannada or English.

5. Elderly citizens who are willing to participate in the study

7.2.4 EXCLUSION CRITERIA:

1. Elderly citizens with contagious diseases.

2. Elderly citizens who are selected for pilot study.

3. Elderly citizens with sensory impairment.

13

7.2.5 TOOLS FOR DATA COLLECTION:

A structured knowledge questionnaire is used to collect the data from the Elderly citizens.

7.2.6 DATA ANALYSIS METHOD:

The data collected will be analyzed by using descriptive and inferential statistics

Descriptive statistics:

Frequency and percentage for analysis of demographic data and mean, mean percentage and standard

deviation will be used for assessing the level of knowledge.

Inferential statistics:

Chi-square test will be used to find out the association between knowledge of Elderly citizens and selected

their demographic variables. Paired‘t’ test will be used for evaluating the effectiveness of Self Instructional

Module.

7.3 DOES THE STUDY REQUIRE ANY INVESTIGATION OR INVESTIGATIONS TO BE

CONDUCTED ON PATIENTS OR HUMANS OR ANIMALS?

Since the study is Pre experimental in nature, investigation or interventions are required.

7.4 ETHICAL CLEARENCE:

Yes, ethical committee’s is here with enclosed. The main study will be conducted after the approval of

research committee of the college. Permission will be obtained from the head of the institution. The purpose and

details of the study will be explained to the study subjects and assurance will be given regarding the confidentiality

of the data collected.

LIST OF REFERENCES (VANCOUVER METHOD FOLLOWED)

14

1. Francesca moret, Introduction to pet therapy. Available from: http://www.investopedia.com

2. Diana De Ronch Depression In Older Adults And The Elderly. Available from: Http://Www.Helpguide.Org.

3. Virginia Bernabe. Pets for the Elderly: A Therapeutic Match. Available from: Http://Www.Helpguide.Org.

4. Susie McGee .Pet therapy in elderly people. Available from :http://seniors.lovetoknow.com/Pet Therapy

5. Oldage is a big stress.16 June 2005 . Available from: http://www.dailymail.co.uk

6. Barbara Ferrari, Claudia Forlani. The Effects Of Pet Therapy. Available

From:Http://Onlinelibrary.Wiley.Com.

7. A. Etemadi and K. Ahmadi, Widmer R. The influence of pet therapy on health. 2007 Oct 20;137(41-

42):581-5. Available from: http://www.ncbi.nlm.nih.gov

8. Lo R , Brown R. Stress and adaptation: effect of pet therapy. 1999 Mar;8(1):30-8. Available from:

http://www.ncbi.nlm.nih.gov

9. Marcus et al. Dog therapy in pain management. 2011 Jan-Feb;145(1):59-72. Available from:

http://www.ncbi.nlm.nih.gov

10. Kingsley Jones . Psychological Problems in the Elderly. 1984 March; 30: 591–593.Available from:

http://www.ncbi.nlm.nih.gov/pubmed . 15

11. Brickel, C.M. 1980. A review of the roles of pet animals in psychotherapy and with the elderly.

International Journal of Aging and Human Development. 12(2):119-28. Available from:

http://www.ncbi.nlm.nih.gov/pubmed

12. Dembicki, D., Anderson, J. 1996. Pet ownership may be a factor in improved health of the elderly.

Journal of Nutrition for the Eldery 15(3):15-31. Available from: http://www.ncbi.nlm.nih.gov

13. Mahalski, P.A., et al. 1988. The value of cat ownership to elderly women living alone. International

Journal of Aging and Human Development. 27(4):249-60. Available from:

http://www.ncbi.nlm.nih.gov

14. Raina, P., Waltner-Toews, D., et al. 1999. Influence of companion animals on the physical and

psychological health of older people: An analysis of a one-year longitudinal study. Journal of the Americal

Geriatrics Society. 47(3):323-29.Available from: http://www.ncbi.nlm.nih.gov

15. Smith, D.W.E., et al. 1992. Pet ownership by elderly people: two new issues. International Journal of Aging

and Human Development. 34(3):175-84.

Available from: http://www.ncbi.nlm.nih.gov/pubmed

16. Wilson, C.C., Netting, E.E. Companion animals and the elderly: a state-of-the-art summary. Journal of the

American Veterinary Medical Assoc. 1983 Dec 15; 183(12):1425-9.

, Available from: http://www.ncbi.nlm.nih.gov

17. Julia K. Vormbrock and John M. Grossberg. Effect of dog therapy on reducing blood pressure. 1988.

Available from: http://www.ncbi.nlm.nih.gov .

16

17

Signature of the Candidate

Remarks of the Guide

Name and Designation of

11.1 Guide

11.2 Signature

11.3 Co-Guide

11.4 Signature

11.5 Head of Department

11.6 Signature

12.1 Remarks of the Chairman &

Principal

12.2 Signature