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UST IACUC
Animal Care and Use Statement
Protocol Review Form

April 2012

University of Santo Tomas


Institutional Animal Care and Use Committee
ANIMAL CARE AND USE STATEMENT
(Protocol Review Form)

UST-IACUC Code: ____________________

Application Fee Received by: _____________


(PRINT Name & Sign)

BAI Certificate No.: ____________________


(For UST-IACUC)
------------------------------------------------------------------------------------------------------------------------Instructions.

(a) Please complete the form by giving all the details asked for.
(b) Have the Protocol Review Form SIGNED and DATED by your respective ADVISER/S
& DEAN.
(c) Submit the accomplished Protocol Review Form to the IACUC Office at the Research
Center for the Natural Sciences (Rm. 202 TARC) for review and approval prior the conduct
of the scientific work involving animals.

RESPONSIBLE PERSON OR PRINCIPAL INVESTIGATOR [PRINT Complete Name,


Student Number & Contact Details (cell phone number and email address)]
EVE ROXANNE APOSTOL V. (2009008870, 09151080692, roxanneapostol@yahoo.com)
NICOLE KRISTINE B. BAGUIO (2009008872, 09064409557, msquiet_17@yahoo.com.ph),
MARIA ALICA C. COSCOS (2009008883,09065284430, alicacoscos@gmail.com) and
ADRIANNE MIKAELLE H. GASPAR (2009009295, 09175783011, mikaelle30@yahoo.com)

NAME OF ADVISER/S &/OR CO-ADVISER/S [PRINT Complete Name, College of


Affiliation & Contact Details (cell phone number and email address)]
Prof. Emerita C. Simeon, Ph.D., College of Science___________________________________

PROCEDURE(S) OR TITLE OF RESEARCH/STUDY:


Comparative Effect of Malunggay (Moringa oleifera) and Banana (Musa paradisiacal) as
Supplementary Feed on the Growth Performance of Broiler Chickens

PURPOSE/OBJECTIVES:
This study aims to compare the growth performance of broiler chicken using Malunggay and
Banana leaf meals added to commercial ration, to distinguish which leaf meal is more effective
for broiler chickens, to compare whether 30% concentration of leaf meal added to the usual feed
is more effective than standard commercial ration, to determine whether more chickens fed with
malunggay leaf meal survive than the chickens fed with banana leaf meal and vice-versa, and
lastly, to determine which leaf meal is more consumed by chickens._______________________
DURATION OR TIME FRAME:
_35 days of brooding ____________________________________________________________
______________________________________________________________________________
BACKGROUND AND SIGNIFICANCE OF THE PROCEDURE OR RESEARCH:
This study would help poultry raisers by providing them with an alternative feed that is cheaper,
easy to prepare and would promote the growth performance of chickens. . Furthermore, this study
would also help them gain more profit since the heavier the chicken, the higher amount that it can be
sold. This study will also help in determining which plant meal malunggay leaf meal or banana
leaf meal is more effective in the growth performance of chickens and thus will offer additional
information on these plants.
_
____
_________________________________________________________________________________

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UST IACUC
Animal Care and Use Statement
Protocol Review Form

April 2012

DESCRIPTION OF METHODOLOGIES/EXPERIMENTAL DESIGN:


A. Type of animal used:
Broiler chickens (Gallus gallus domesticus)
B. Source of the animals:
Hatchery in Pulilan, Bulacan
C. Reason/Basis for selecting the animal species:
Broiler type of chickens are the ones being sold in the market and consumed by humans as
source of poultry meat. It is specifically raised for meat production because of their fast
growing rate, high feed conversion ratio, and low level of activity.
D. Sex and number of animals:
Number of Animals per Treatment (Maximum of 6)
Total Number of Animals:

________6___________
_______54__________

E. Quarantine and/or acclimation or conditioning process


Indicate where: _Pulilan, Bulacan__________________
Duration
_____10 days______________
Conditions:____________________________________________________________________
______________________________________________________________________________
F.

Animal care procedures

1. Cage Type & Size: 1.4m x 1.4m x 0.9m

Type of Bedding: ___For sanitation purposes the broiler chicks will be put under
maintenance utilizing litter system by using newspapers or old sacks to cover the floor of the___
pen.______
2. Number of animals per cage
Six animals per cage____________________________________________________
______________________________________________________________________________
3. Cage cleaning method
_Glutaraldehyde will be used to disinfect the brooder house and other equipments
____________________________________________________________________
4. Room temperature, humidity, ventilation and lighting
__Room temperature varies to the age of the broiler chickens. Incandescent light will be
used during early days of the chicks and will be replaced by fluorescent light
________________________________________
5. Animal diet and feeding and watering method
Feed: ___________________
Source:
Plants (Backyard), Commercial
rations (Store)
Water: ___________________
Source:
___________________
_____________________________________________________________________
______________________________________________________________________________
A. Experimental or animal manipulation methods
1. General description of animal manipulation methods
_____________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
2. Dosing method
__30% powdered Malunggay leaves additional to the standard commercial feeds and
30%
powdered
banana
leaves
additional
to
the
standard
commercial
feeds._________________________________________________________________
3.
Specimen or biological agent
_____________________________________________________________________
______________________________________________________________________________

UST IACUC
Animal Care and Use Statement
Protocol Review Form

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April 2012

______________________________________________________________________________
4.
Animal examination procedures and frequency of examinations
_Animals will be weighed individually once a week____________________________
______________________________________________________________________________
5.
Use of anesthetics
_NA_________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
6.
Surgical procedures
_NA_________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
7.
Euthanasia
_NA_________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
8.
Animal Adoption / Disposal
_NA_________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
B. Is there a non-animal model applicable for the procedure/study? If so, please provide the
reasons for not using it.
_None___________________________________________________________________________
______________________________________________________________________________
C. Indicate the names and qualifications of all personnel who will be responsible for
conducting the procedures.
EVE ROXANNE APOSTOL V. NICOLE KRISTINE B. BAGUIO MARIA ALICA C.
COSCOS and ADRIANNE MIKAELLE H. GASPAR

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UST IACUC
Animal Care and Use Statement
Protocol Review Form

April 2012

DECLARATION BY THE RESPONSIBLE PERSON:


I ACCEPT RESPONSIBILITY FOR ASSURING THAT THE PROCEDURES/ STUDY
WILL BE CONDUCTED IN ACCORDANCE WITH THE APPROVED PROTOCOL.
I ASSURE THAT ALL PERSONNEL WHO USE THIS PROTOCOL AND WORK WITH
ANIMALS, HAVE RECEIVED APPROPRIATE TRAINING/ INSTRUCTIONS IN
PROCEDURAL AND HANDLING TECHNIQUES, AND ON ANIMAL WELFARE
CONSIDERATIONS.
I AGREE TO OBTAIN WRITTEN APPROVAL FROM THE INSTITUTIONAL ANIMAL
CARE AND USE COMMITTEE PRIOR TO MAKING ANY CHANGES AFFECTING
MY PROTOCOL. I ALSO AGREE TO PROMPTLY NOTIFY THE IACUC IN WRITING
OF ANY EMERGENT PROBLEMS THAT MAY ARISE IN THE COURSE OF THIS
STUDY, INCLUDING THE OCCURRENCE OF ADVERSE SIDE EFFECT.
Signature over Printed Name of the Responsible Person:

________________________
Principal Investigator

Date: ______________________

Noted by:

___________________________
Adviser

Date: ______________________

_____________________________
Dean, Faculty/College

Date: ______________________

SONIA P. IBARRIENTOS, DVM

Date: _____________________

Institutional Veterinarian