SYNOPSIS

BATCH 17
4TH YEAR MBBS
KING EDWARD MEDICAL
UNIVERSITY, LAHORE
Title of Research Project:

Synopsis Submitted For: Discipline:

MD / MS / MDS Ph. D
M. Phil Research Grant
Name Of The Applicant: D.O.B

Nationality: NIC #:

Address:

Phone #: Email:

Qualifications (list all; with date of graduation):

Qualification Year Institution

Practical Experience (list all; with dates of employment):

Title of Research Project:

Synopsis Submitted For: Discipline:

MD / MS / MDS Ph. D
M. Phil Research Grant
Name Of The Applicant: D.O.B

Nationality: NIC #:

Address:

Phone #: Email:

Qualifications (list all; with date of graduation):

Qualification Year Institution

Practical Experience (list all; with dates of employment):

TITLE:
Evaluation of Physical Activity in
association with BMI in Primary School
Children in Lahore
INTRODUCTION:
Physical inactivity and sedentary lifestyle in children and adolescents are raising health burdens
worldwide and is one of the established risk factors for mortalityˡ¹ˡ. Where high fitness is shown
to counterbalance many adiposity related health issues, low physical activity and sedentary
lifestyle is mostly associated with obesity, cardiovascular diseases and poor psychological well
beingˡ²ˡ. Moderate to vigorous physical activity increases the energy expenditure to almost three
times the basal metabolic rate which has many beneficial effects on physical and mental health,
particularly on cardiovascular systemˡ³ˡ.

A study conducted in a school of Cameroon showed that physical activity had inverse
relationship with adiposity and triceps skin fold thickness. It showed that those who exercise less
than 2 times per week had higher triceps skin fold thickness and vice versaˡ⁴ˡ. Another study
conducted in adolescents of South Africa concluded that only 26% met the international
guidelines of 60 minutes of moderate-to-vigorous activity per day. It also showed an increase in
sedentary time and a decrease in physical activity with increase of age in pubertal femalesˡ⁵ˡ. In
another study conducted in Kenya, only 12.6% met the standard 60 minutes of MVPA criterion.
14.4% students were found to be overweight while 6.4% were obese according to the standards
set by WHO. More adiposity was associated with physical inactivity and use of motorised
transportˡ⁶ˡ.

Pakistan is also facing an increased trend in childhood obesity despite the fact that a large portion
of population is undernourished. Inactive lifestyle, poor food choices and more leisure time is its
major cause. A study conducted in a primary school of Lahore found out that those who spent
more than 1 hour in leisure activities were more likely to be overweight/obese while those who
participate in physical activity more than 2 times every week were less likely to be
overweight/obeseˡ⁷ˡ. Another study held in Lahore showed that out of 293 school students, 48.6%
didn’t participated in any sports and 34.3% spent less than 3 hours in sports fieldˡ⁸ˡ. A major
cause of physical inactivity in Pakistan is lack of school administration’s interest towards
physical fitness of students. A study was conducted in public and primary schools in Hyderabad,
Pakistan that showed that majority of school (44%) did not offer Physical Activity classes as a
part of their curriculum and 77% didn’t offer any opportunity to participate in any sportsˡ⁹ˡ.

Because of the increasing public health importance of childhood obesity and the dearth of
official statistics and up-to-date studies on children's health and well-being, studies such as this
are necessary to gauge the consequences of increasing physical inactivity, obesity and unhealthy
lifestyles among children.
OBJECTIVES:
• To quantify the present status of physical activity among primary school children
• To record the status of physical activity among primary school children.
• To assess the average physical activity of children and its association with sedentary
habits and BMI
OPERATIONAL DEFINITIONS:
i. Physical Activity:
The Physical Activity Guidelines for Americans recommend that children and adolescents
participate in at least 60 minutes of moderate-to-vigorous physical activity most days of the
week, preferably daily, in order to attain health benefits.
ii. Primary School Children:
In Pakistan, students from class 1 to 5 are counted as primary school children.
iii.Underweight:
Those children, having BMI below 18.5 are considered underweight.
iv.Normal Weight:
BMI between 18.5 and 24.9 is considered normal.
v. Overweight:
Those having BMI between 25 and 29.9 are considered overweight.
vi. Obese:
Those having BMI greater than 30 are counted as obese.
MATERIALS AND METHODS:

Study design:
Descriptive study → Cross-sectional study
Study setting:
4 Primary Schools, Lahore.

Study population:
Children studying in primary schools grade 5, aged 10-11 years.
Study duration:
January 10, 2019 – September, 2019.

Sample size:
Given the margin of error = 5%, confidence level = 95%, population size = 500 and response
distribution = 50%, the recommended sample size calculated on Raosoft online sample size
calculator is 218. The sample size will be rounded about to 200. The margin of error in the
sample size of 200 would be 5.37 %.
In terms of the numbers we selected above, the sample size n and margin of error E are given by:
x = Z(c/100)2r(100-r)
n = Nx / ((N-1)E2+x)
(N-n)x
E = Sqrt[ /n(N-1)]
Here, N is the population size, x is a variable, r is the fraction of responses that we are interested
in, Z(c/100) is the critical value for the confidence level c and Sqrt is the square root.

Sampling technique: Non-Probability sampling → Convenience sampling.

Sample selection:
• Inclusion criteria:
-Written consent with School's principal and class teacher will be used as a prerequisite to
include the respondents
- Students who are enrolled in grade 5
• Exclusion criteria:
-Those who will not give the written consent will be excluded from the study.
-Students who are not enrolled in grade 5
DATA COLLECTION:
Data will be collected using a standardized and pre-tested structured questionnaire. The
questionnaire developed by the research team is based on the previous knowledge. The ideas
included in the questionnaire are taken from multiple sources. Any ambiguous questions which
can be misinterpreted, were rephrased until the research team was satisfied that the questions are
clearly understandable for the children and culturally appropriate. (2) The questionnaire are
developed both in English and Urdu languages. Each respondent will be given 25 – 30 minutes
to complete the questionnaire. Demographic data form is also constructed by the research team
considering the previous knowledge. Demographic characteristics include gender, age,
educational level, total number of children, occupation and monthly income. The frequency (f),
Percentage (%) ,Mean ± SD and Median of the study group will be calculated according to each
of their demographic characteristics where:
• f is the total number of individuals with a specific demographic characteristic
• % means “for every 100” or "out of 100 (3)
• The formula to calculate Mean (4) is as follows:
x = Ʃx / N
Here, Ʃ represents the summation, x represents scores and N represents number of cases.
• The formula to calculate the Standard deviation (SD) (5) is as follows:

To calculate the standard deviation of the given numbers:

Work out the Mean (the simple average of the numbers)
Then for each number: subtract the Mean and square the result)
Then work out the mean of those squared differences
Take the square root of that and we are done
Here, σ is the standard deviation, μ is the mean of all the given values, xi represents the
individual x(variable) values, N is the total number of the values. The handy Sigma Notation
∑𝑁𝑖=1(𝑥𝑖 − 𝜇)2 says to sum up as many terms as one want. We start at this value i=1 and go up
to this value N. We want to add up all the values from 1 to N
• The formula to calculate the median (4) is as follows:
If the total number of the numbers (n) is an odd number;
Median = (n+1 / 2)th term
If the total number of the numbers (n) is an even number;
Median=(n / 2)th term+(n / 2+1)th term / 2
DATA ANALYSIS:
The data will be entered and analysed in the IBM SPSS software. Chi square test will be used to
calculate the statistical significance of the p value.
The formula for the chi-square statistic (6) used in the chi square test is:

The subscript “c” are the degrees of freedom. “O” is your observed value and E is your expected
value.

OUTCOMES:
The suggestion of alternative solutions to the present problem of obesity, physical activity and
improper lifestyle choices

The problem of sedentary lifestyle in children had risen to a vast extent in the past years at both
national and international level. The reason being children spending more time in indoor
activities. The schools are a place where they can show maximum participation in physical
activity. This is to evaluate the participation of individuals in different physical activities in
primary schools.
SCHEDULE/PHASING:

Work PLAN JAN FEB MA APR MA JUN JULY AUG SEPT

ACTIVITES U R R I Y E UST EMB
ARY UAR CH L ER
Y
TITLE SELECTION
INTRODUCTION
OPERATIONALIZATI
ON
AND
CONCEPTUALIZATI
ON
TOOL
DEVELOPMENT
FINAL SYNOPSIS
REVIEW
DATA COLLECTION
DATA ANALYSIS
FINAL THESIS
SUBMISSION
REFERENCES:

Lee CD, Blair SN, Jackson AS, Cardiorespiratory fitness, body composition, and all-cause and
cardiovascular disease mortality in men. Am J Clin Nutr. 1999 Mar; 69(3):373-80.
Ussher MH, Owen CG, Cook DG, Whincup PH. The relationship between physical activity,
sedentary behaviour and psychological well being among adolescents. Soc Psychiatry Psychiatr
Epidemiol. 2007;42(10):851–856. Pmid:17639309
Iannotti RJ, Janssen I, Haug E, Kololo H, Annaheim B, Borraccino A, et al. Interrelationships of
adolescent physical activity, screen-based sedentary behaviour, and social and psychological
health. Int J Public Health. 2009;54 Suppl 2:191–198.
Lifoter K. Navti, Mary B. Atanga, Loveline L. Niba, Associations of out of school physical
activity, sedentary lifestyle and socioeconomic status with weight status and adiposity of
Cameroon children. 2017; 4: 35. 10.1186/s40608-017-0171-3
Micklesfield LK, Pedro TM, Kahn K, Kinsman J, Pettifor JM, et al. Physical activity and
sedentary behavior among adolescents in rural South Africa: levels, patterns and correlates.
BMC Public Health. 2014;14:40. doi:
10.1186/1471-2458-14-40.
Mathuri SK, Wachira LI, Onywera VO, Tremblay MS. Correlates of objectively measured
overweight/obesity and physical activity in Kenyan school children: results from ISCOLE-
Kenya. BMC Public Health. 2014;14:436. doi: 10.1186/1471-2458-14-436
Mushtaq MU, Gull S, Mushtaq K, Shahid U, Shad MA, Akram J,Dietary behaviors, physical
activity and sedentary lifestyle associated with overweight and obesity, and their socio-
demographic correlates, among Pakistani primary school children, Int J Behav Nutr Phys Act.
2011 Nov 25; 8():130.
Anwar A, Anwar F, Joiya HU, Ijaz A, Rashid H, Javaid A, et al,Prevalence of obesity among the
school-going children of Lahore and associated factors.2010 Oct-Dec;22(4):27-32.
Jamil Ahmed, Vikram Mehraj,Gotam Kumar Jeswal, Shafiq ur Rehman, Sayed Masoom Shah,
Randah Hamadeh, PARENTAL AND SCHOOL INFLUENCES ON PHYSICAL ACTIVITY
LEVELS OF HIGH SCHOOL STUDENTS IN HYDERABAD, PAKISTAN,2016;28(1):110
DATA COLLECTION INSTRUMENT:

CONSENT FORM

I Voluntarily agree to take part in this study titled

TITLE OF STUDY

I have read and understand the above information. I understand that my participation is
voluntary and that I am free to withdraw at any time. I have been assured that all the records
will be kept confidential and the identity will be treated confidential

Participant Name ______________

Participant Signature____________
CNIC No: _________________
Date:_________________

Investigator's Signature
Date:______________

We are trying to find out about your level of physical activity from the last 7 days (in the last
week) This includes sports that make you sweat or make your legs feel tired, or games that
make you breathe hard, like tag, skipping, running, climbing and others.
Remember
1. there are no right and wrong answers this is not a test
2. Please answer all the questions as honestly and accurately as you can, this is very important.
AGE(years):_______ HEIGHT(cm)
WEIGHT(Kg):_________

1. In the last 7 days, during your physical education (PE) classes, how often were you very
active (playing hard, running, jumping, throwing)? (Check one only.)
I don’t do PE
Hardly ever
Sometimes
Always
2. In the last 7 days, What did you normally do at lunch(Besides eating lunch)? (Check one
only)
Sat down (talking, reading, doing school work)
Stood around or walked around
Ran or played a little bit
Ran around and played quite a bit
Ran and played hard most of the time
3. In the last 7 days, on how many days right after school, did you do sports or play games in
which you were very active? (Check one only)
None
1 time last week
2 or 3 times last week
4 times last week
5 times last week
4. In the last 7 days, on how many evenings did you sports, or play games in which you were
very active? (Check one only)
None
1 time last week
2 or 3 times last week
4 or 5 times last week
6 or 7 times last week
5. On the last weekend, how many times did you do sports, or play games in which you were
very active(check one only)
None
1 time last week
2 or 3 times last week
4 or 5 times last week
6 or 7 times last week
6. On the last 7 days, how many times did you use internet, your laptop, play video games,
watch TV, or just lay around? (check one only)
None
1 time last week
2 or 3 times last week
4 or 5 times last week
6 or 7 times last week
7. In the last 7 days, how many times did you go out with friends, and if you did, did you
engage in any physical activity?
None(No Physical Activity)
1 time Minor Physical Activity
2 or 3 times (Moderate Physical Activity)
4 or 5 times (Major Physical Activity)
6 or more times (Extreme Physical Activity)
8. Which one of the following describes you best for the last 7 days? Read all five statements
before deciding on the one answer that describes you
A. All or most of my free time was spent doing things that involve little physical effort
B. I sometimes (1-2 times last week) did physical things in my free time (e.g. played sports,
went running, swimming, bike riding, did acrobatics)
C. I often (3-4 times last week) did physical things in my free time.
D. I often (5-6 times last week) did physical things in my free time.
E. I very often (7 or more times last week) did physical things in my free time.
9. Mark how often you did physical activity (like playing sports, games, or any other physical
activity) for each day last week.

None Little bit Medium Often Very Often

Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday

10. Were you sick last week, or did anything prevent you from doing your normal physical

activities?(Check one)

Yes
 ‫‪No‬‬

‫________ ?‪If Yes, What prevent you‬‬

‫رضامندی فارم‬
‫میں رضاکارانہ طور پر "الہور کے پرائمری سکولوں میں جسمانی‬
‫سرگرمی کا مطالعہ" نامی اس مطالعہ میں حصہ لینے پر رضامندی کا‬
‫اظہار کرتا ہوں۔‬

‫میں نے مندرجہ باال معلومات کو پڑھا اور سمجھا ہے‪ .‬میں سمجھتا ہوں‬
‫کہ میری شراکت رضاکارانہ ہے اور میں کسی بھی وقت واپس کرنے‬
‫کے لئے آزاد ہوں‪ .‬مجھے یقین ہے کہ تمام ریکارڈ خفیہ رکھیں گے اور‬
‫میری شناخت خفیہ رکھی جائے گی‬

‫شرکاء کا نام ______________‬

‫شراکت دار دستخط ________‬
‫‪ CNIC‬نمبر‪_________________ :‬‬
‫تاریخ‪_________________ :‬‬

‫تحقیقاتی کا دستخط‬
‫تاریخ‪______________ :‬‬
‫ہم گزشتہ ‪ 7‬دنوں سے اپنے جسمانی سرگرمی کے بارے میں تالش کرنے کی کوشش کر رہے ہیں (پچھلے ہفتہ میں) اس کھیلوں میں‬
‫شامل ہوسکتا ہے جو آپ کو پتلون بناتے ہیں یا آپ کے ٹانگوں کو تھکاوٹ محسوس کرتے ہیں‪ ،‬یا ایسے کھیلوں کو جو آپ کو مشکل‬
‫سانس لینے‪ ،‬ٹیگ‪ ،‬چل رہا ہے‪ ،‬چڑھنے اور دیگر‬
‫یاد رکھیں‬
‫کوئی صحیح اور غلط جواب نہیں ہیں یہ ایک ٹیسٹ نہیں ہے_‪. -‬‬
‫براہ کرم تمام سواالت ایمانداری اور درست طریقے سے کریں جیسا کہ آپ کر سکتے ہیں کہ یہ بہتاہم ہے ‪.‬‬
‫)سال( ‪______AGE‬‬
‫)سینٹی میٹر( ‪______ HEIGHT‬‬
‫وزن _______‬
‫گزشتہ ‪ 7‬دنوں میں‪ ،‬آپ کی جسمانی تعلیم (پی ای)کی کالسوں کے دوران‪ ،‬آپ کتنی بار اکثر فعال تھے (کھیلنا مشکل تھا‪ ،‬بھاگنا‪،‬‬
‫کودنا‪ ،‬پھینکنا)؟ (صرف ایک چیک کریں‬
‫‪1‬میں فزیکل ایجوکیشن نہیں کرتا‬
‫‪2‬مشکل سے ہی کبھی‬
‫۔‪3‬کبھی کبھی‬
‫۔‪4‬ہمیشہ‬
‫عالوہ)؟ (صرف ایک چیک کریں گزشتہ ‪ 7‬دنوں میں‪ ،‬آپ نے عام طور پر دوپہر کا کھانا کیا (دوپہر کا کھانا کھانے کے(‬
‫)بیٹھ کر (بات کرنے‪ ،‬پڑھنے‪ ،‬اسکول کا کام کر‬
‫چلنا پھرنا اور کھڑے رہے‬
‫کچھ کھیل کود اور دوڑ کی‬
‫زیادہ تر زیادہ کھیلے دوڑے‬
‫گزشتہ ‪ 7‬دنوں میں‪ ،‬اسکول کے بعد کتنا دن ٹھیک ہے‪ ،‬کیا آپ نے کھیلوں کو کیا یا کھیلوں میں کھیل کیا جس میں آپ بہت فعال تھے؟‬
‫)(صرف ایک چیک کریں‬
‫کوئی بھی نہیں‬
‫گزشتہ ہفتے ‪ 1‬ہفتہ‬
‫گزشتہ ہفتے ‪ 2‬یا ‪ 3‬بار‬
‫گزشتہ ہفتے ‪ 4‬بار‬
‫گزشتہ ہفتے ‪ 5‬بار‬
‫گزشتہ ‪ 7‬دنوں میں‪ ،‬تم نے کتنی بار تم کھیلوں کی‪ ،‬یا اس کھیل کو کھیلنے کے لئے جس میں آپ بہت فعال تھے؟ (صرف ایک چیک‬
‫)کریں‬
‫کوئی بھی نہیں‬
‫گزشتہ ہفتے ‪ 1‬ہفتہ‬
‫گزشتہ ہفتے ‪ 2‬یا ‪ 3‬بار‬
‫پچھلے ہفتے ‪ 4‬یا ‪ 5‬مرتبہ‬
‫پچھلے ہفتے ‪ 6‬یا ‪ 7‬مرتبہ‬
‫گزشتہ ہفتے کے اختتام پر آپ کتنے بار کھیلوں کرتے ہیں یا اس کھیل کو کھیلتے ہیں جس میں آپ بہت فعال تھے (صرف ایک چیک‬
‫کریں‬
‫کوئی بھی نہیں‬
‫گزشتہ ہفتے ‪ 1‬ہفتہ‬
‫گزشتہ ہفتے ‪ 2‬یا ‪ 3‬بار‬
‫پچھلے ہفتے ‪ 4‬یا ‪ 5‬مرتبہ‬
‫پچھلے ہفتے ‪ 6‬یازیادہ مرتبہ‬
‫گزشتہ ‪ 7‬دنوں میں‪ ،‬آپ نے انٹرنیٹ‪ ،‬کتنے بار آپ کا لیپ ٹاپ‪ ،‬ویڈیو گیمز کھیلنے‪ ،‬ٹی وی دیکھتے ہیں‪ ،‬یا صرف ارد گرد گھومنے‬
‫کا کتنا بار استعمال کیا؟ (صرف ایک چیک کریں‬
‫کوئی بھی نہیں‬
‫گزشتہ ہفتے ‪ 1‬ہفتہ‬
‫گزشتہ ہفتے ‪ 2‬یا ‪ 3‬بار‬
‫پچھلے ہفتے ‪ 4‬یا ‪ 5‬مرتبہ‬
‫پچھلے ہفتے ‪ 6‬یا زیاد مرتبہ‬
‫گزشتہ ‪ 7‬دنوں میں‪ ،‬آپ کتنے بار دوستوں کے ساتھ باہر گئے تھے‪ ،‬اور اگر آپ نے کیا‪ ،‬کیا آپ کسی جسمانی سرگرمی میں ملوث‬
‫تھے؟‬
‫)کوئی بھی جسمانی سرگرمی نہیں‬
‫‪1‬دفعہ معمولی جسمانی سرگرمی‬
‫‪3‬دفعہ درمیانی جسمانی سرگرمی‬
‫‪4‬سے ‪5‬دفعہ بنیادی جسمانی سرگرمی‬
‫‪6‬یا زائد دفعہ انتہائی جسمانی سرگرمی‬
‫پچھلے ‪ 7‬دنوں میں آپ میں سے کونسی ایک سے بہترین بیان کرتا ہے؟ ایک جواب پر فیصلہ کرنے سے قبل تمام پانچ بیانات پڑھیں‬
‫جو آپ کی وضاحت کرتی ہیں‬
‫الف ‪ :‬یا میرے فارغ وقت کا سب سے زیادہ کام کرنے والے چیزوں کو خرچ کر رہا تھا جس میں کچھ جسمانی کوششیں شامل ہیں‬
‫ب ۔ میں نے کبھی کبھی (گزشتہ ہفتے ‪ 2-1‬مرتبہ) جسمانی چیزوں کو اپنے فارغ وقت میں کیا (جیسے کھیلوں کو چالتے ہوئے‪. ،‬‬
‫)چل رہا تھا‪ ،‬تیراکی‪ ،‬موٹر سائیکل کی سواری‪ ،‬اکھلیت پسندیاں‬
‫ت ۔میں اکثر (آزادانہ طور پر ‪ 4-3‬بار) نے اپنے مفت وقت میں جسمانی چیزوں کو کیا ‪.‬‬
‫ج ۔ میں اکثر (میرے پچھلے ہفتے ‪ 6-5‬بار) نے اپنے آزاد وقت میں جسمانی چیزوں کو کیا ‪.‬‬
‫د میں اکثر اکثر (گزشتہ ہفتے ‪ 7‬یا اس سے زیادہ بار) نے اپنے مفت وقت میں جسمانی چیزوں کو کیا ‪.‬‬
‫گزشتہ روز ہر روز کے لئے آپ نے جسمانی سرگرمی (جیسے کھیلوں‪ ،‬کھیلوں یا کسی دوسری جسمانی سرگرمی کو چالنے کی‬
‫طرح) کتنی نشان زد کیا ہے‬
‫‪.‬‬
‫اکثر‬ ‫اکثر‬ ‫درمیانہ‬ ‫تھوڑا بہت‬ ‫کوئی‬
‫اوقات‬ ‫نہیں‬
‫اتوار‬
‫پیر‬
‫منگل‬
‫بدھ‬
‫جمعرات‬
‫جمعہ‬
‫ہفتہ‬
‫)کیا آپ گزشتہ ہفتے بیمار تھے؟ یا کسی وجہ سے آپ معمول کی جسمانی سرگرمیاں نہ کر سکے ؟ کسی ایک پر چیک کریں‬

‫‪.‬جی ہاں‬

‫نہیں‬

‫اگر ہاں‪ ،‬تو کس وجہ سے ؟‬

 Sanctity of data - Affidavit
I,Mr/Ms_________________________________________________S/o___________________
______
Student
of___________________________________________________________________________
working in _____________________________
Under Supervisorship of __________________________________

Hereby undertake to abide by the following rules

1. That the data collected during my attachment at King Edward Medical University
(to be call KEMU here after) for which authorization is being granted by the
Institutional Review Board ( to be called IRB here after) of KEMU for which I have
submitted my synopsis
titled___________________________________________________________________
_____________________________________________________ shall be used
exclusively for the purpose of “not for profit” research and will not use for any other
purpose what so ever. Any financial gain or patent originating from this research
shall be equally shared with KEMU.
2. The data collected shall be strictly limited to the parameters defined in my synopsis
titled
_______________________________________________________________________
____________________________________________________
3. That the identity of patients (cases) shall not be revealed.
4. That prior approval for research project (synopsis) has been obtained from the
Institutional Review Board/ Ethical Committee of my parent institution.
5. That appropriate recognition and acknowledgement shall be given to KEMU in the
publication of the paper/papers or any other medium of communication what so ever,
if it utilizes the data/ graphs/tables/pictures collected from the aforementioned
research, furthermore, in any subsequent publication or any other medium of
communication what so ever, if it utilizes the above mentioned
data/graphs/tables/pictures with proper acknowledgement (as mentioned below) and
with prior intimation and authorization of IRB of KEMU.
6. The aforementioned acknowledgement/recognition shall be mutually decided
between the principal investigator (myself) and the in charge of the unit concerned at
KEMU, under intimation to the IRB of KEMU.
I have read all the clauses of the above written agreement and hereby agree to
be legally bound to this agreement in letter and spirit. I also understand that if
I am in breach of this contract; I shall lose the right to the
data/publication/graphs/tables collected/published (stored in any form
physical/electronic) thereof. In addition, KEMU will reserve the right to initiate
proceedings against me at any/all for a deemed appropriate. Research
Supervisor (as shown below) shall stand witness and guarantor of this
agreement and would be equally liable in case of breech of agreement.

Signature (Principal Investigator) Signature of Supervisor

NIC No.____________________ NIC No.____________________

Proforma for Evaluation of Research Synopsis
Board of Studies
NOTE: (It should be filled in by All Members of BOS individually)
Title:________________________________________________________________
____________________________________________________________________
____________________________________________________________________
___

A. Must fulfill all of the following.

Sr.No. Essential Criterion No Yes

1. According to prescribed format ✓
2. Principal Investigator and Co investigator mentioned ✓
3. Consent form given ✓
4. Proforma for data collection given ✓
5. Follow up proforma given ✓
6. Non-compliance with previous research protocol ✓
7. Repitition of Study ✓

B. Kindly evaluate this research proposal and grade the research proposal
against each item. Must get at least 1 in all sections to qualify. Please check the
appropriate box.

Sr. No. Criterion Grading

1. Novelty of research idea 0 1 2 3 4 5
2. Potential for capacity building (Skills) 0 1 2 3 4 5
3. Multidisciplinary 0 1 2 3 4 5
Contribution of research topic
4. 0 1 2 3 4 5
towards public benefit
Contribution of research topic
5. 0 1 2 3 4 5
towards medical knowledge

Total Score 25 Score

Obtain
Name:____________________________ Signature: __________________________
 COMPLETE BREAK UP OF THE ITEMS
REQUIRED FOR RESEARCH GRANT
KING EDWARD MEDICAL UNIVERSITY, LAHORE

Unit Price Total Price

Sr. # Particulars Quantity
Including Taxes Including Taxes

TOTAL

Researcher Signature:___________ Supervisor Signature:__________

 List of Required Documents For Approval of
Institutional Review Board

➢ Informed Consent Form in English and Urdu

➢ Subject Recruitment Procedure
(e.g OPD, Indoor, Advetisement)
➢ Investigator’s Brochure and Available Safety
Information for Patient
(Please devise patient information in urdu detailing the complications, if any, and
benefits of the device/ devices and comparison with conventional technique )
➢ Investigator’s Curriculum Vitae detailing qualification
➢ Sanctity of Data form - Affidavit duly filled in and signed
➢ Detailed Visit Forms
(Please make Seperate Proformas for every visit. Keeping in Mind Inclusion and
Exclusion Criteria)
➢ Minutes of Board Of Studies / Approval of BOS
➢ Proforma for Evaluation of Research Synopsis filled in individually by
members of the Board of Study
➢ Plagiarism Check Report
➢ Soft Copy of Synopsis alongwith soft copy of articles of all
references submit in Research Center on CD.