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Background: Agro-based industrial works like flour milling are a significant component in the industrial arena of Kerala. In milling industry, dusts are produced in substantial quantities and inhalation of which can result in pulmonary impairment in workers. In such situations, spirometric evaluation can aid in the diagnosis and prognosis of pulmonary diseases. Aims and Objectives: The aims of this study were to assess the effect of flour dust on pulmonary function among flour mill workers and to study the variation in pulmonary function among workers according to duration of exposure and their working environment in the factory. Materials and Methods: A cross-sectional study was conducted in three wheat flour mills. Subjects were selected after proper exclusion and after getting informed consent. In the present study, 79 flour mill workers aged more than 20 years and employed for more than 1year, were considered and their FVC,FEV1,FEV1/FVC,PEFR and FEF25-75% values were assessed. The objective was to find out the effect of their duration of employment and exposure to dust on their spirometric parameters based on their type of job and age. These parameters were tested using a portable electronic spirometer in the factory premises. Results: The study showed no significant relation of these parameters with duration of employment and dust exposure. However, there was significant reduction in FVC and FEV1 with increasing age. Conclusion: Even though apparently normal PFT values are obtained in many subjects, these may be on the extremes of normal spectrum.
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Background: Subclinical hypothyroidism (SCH) reflects the earliest stage of thyroid dysfunction with subjects having normal free thyroid hormones T3, T4 with elevated Thyroid-stimulating hormone (TSH) values. Hypothyroidism may depress the central ventilator control and affects respiratory muscle strength which is linearly related to the thyroid hormone levels. In hypothyroidism, the impairment of pulmonary functions may be initiated at the subclinical stage of hypothyroidism. Aim and Objectives: The present study was designed to derive Forced Vital capacity (FVC), Forced expiratory volume in 1 second (FEV1), FEV1/FVC, Peak expiratory flow rate and FEF 25–75 % in subclinical hypothyroid subjects and to compare the values with that of healthy controls. Materials and Methods: A cross-sectional comparative study was conducted in subjects aged between 25 and 60 years in which 85 subclinical hypothyroid cases were selected after proper exclusion and informed consent. 85 age and sex matched healthy controls were also studied. Statistical package for social sciences version 18 was used for statistical analysis. Results: All spirometric variables were found to be lower in subclinical hypothyroid subjects than in healthy controls and the abnormalities were of mixed pattern-both obstructive and restrictive. All values obtained were statistically significant (P < 0.05). Conclusion: Patients with SCH should be regularly screened with pulmonary function tests as respiratory derangement starts even at this stage. This will help for early diagnosis and treatment, and to prevent future complications.
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Background: Peak expiratory flow rate (PEFR) is a measure of the maximum speed of exhalation after a deep inspiration. The peak expiratory flow is measured by a device named peak flow meter. This study concentrates on the correlation of the PEFR with the pectoral muscle length.Methods: It is a cross sectional study of 30 convenient samples based on gender distribution where the PEFR and pectoralis muscle length were measured in the subjects.Results: Statistical analysis shows that there is a significant correlation between right pectoralis major general muscle length and PEFR (p=0.030), left pectoralis major general muscle length and PEFR (p=0.014), right pectoralis major clavicular end muscle length with PEFR (p=0.010).Conclusions: There is a significant correlation between peak expiratory flow and pectoralis muscle length.
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Many individuals prefer using a pillow under their head when they sleep or read or use hand held electronic devices in recumbent position. Changes in position of the head with respect to the neck in supine posture may occur depending on the use of a pillow or height of the pillow used. This alteration of head and neck position might have an effect on pulmonary ventilation. The Peak Expiratory Flow Rate (PEFR) is one of the tests to assess pulmonary functions and PEFR can be performed easily and rapidly with the help of Wright’s Mini Peak Flowmeter. This study was undertaken to see the effect of variations in neck position on peak expiratory flow rate in supine posture in young healthy adults. METHODSA cross sectional study was carried out on 150 apparently healthy medical students of both sexes in the age group of 18 - 21 years. PEFR values were recorded using Wright’s Mini Peak Flow Meter. The subjects were asked to lie down in supine position on a wooden couch and recording of the peak expiratory flow rate was performed, initially by placing the subject’s head directly on the wooden couch and then by keeping the head on a pillow of 5 cm height. RESULTSData was analysed using paired ‘T’ Test and the p value of less than 0.05 was considered as statistically significant. We found that the mean PEFR value obtained using a pillow of 5 cm height under the head was more than the mean PEFR value obtained without using the pillow and the change in mean PEFR values was statistically significant (Table 1). CONCLUSIONSAfter comparing the mean PEFR values in the supine position with and without use of a pillow, we found that mean PEFR value was significantly higher when PEFR test was performed with use of a low height pillow (5 cm) under the head. From the result of this study, we conclude that pulmonary ventilation is better when the head and neck are supported with a low height pillow in supine posture.
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Background: Many of the studies have put forth the hypothesis that sawdust deteriorates lung function, increases the incidence and prevalence of diseases of the respiratory system, and can predispose to cancer and deaths. Deterioration of lung function can be tested by pulmonary function tests. Several studies have shown respiratory disorders in sawmill workers, including the reduction of pulmonary function tests, but there is a paucity of such studies in Central India; hence, in this study, we tried to study comparative lung function among sawmill workers. Objective: The objective of this study was as follows: (i) To study the lung function of workers in sawmill industry, (ii) comparative assessment of lung function with those of controls, and (iii) to study the effect of occupational exposure to wood dust. Materials and Methods: The study was carried out in the sawmills in Nagpur city from September 2013 to December 2015. Sawmill workers were the study group and local government workers as comparison group. Each worker was examined in a separate room away from the workplace. Spirometry was done to assess the lung function using the UK’s Compact Vitalograph. Subjects in the control group were also examined with the spirometry. The lung function values of sawmill workers compared with the control and the difference in them was assessed both numerically and statistically. Results: Mean of forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), forced expiratory flow25–75, and peak expiratory flow rate was significantly decreased among sawmill workers as compared to control group (P < 0.05), but FEV1/FVC ratio was significantly elevated among sawmill workers (P < 0.05). Conclusion: We have concluded that sawmill workers suffered from obstructive or restrictive type of pulmonary disorder, but the predominant type was restrictive lung disease.
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Introduction:Asthma is a chronic inflammatory condition of the lung airways resulting in episodic airflow obstruction. This chronic inflammation heightens the airway hyper responsiveness (AHR). Asthma is defined by the history of respiratory symptoms like wheeze, shortness of breath, chest tightness and cough that vary over time and in intensity together with variable expiratory airflow limitation.1 Aims & Objectives: To compare the effectiveness of a combination of inhaled anticholinergics (ipratropium bromide) and beta 2 agonists (salbutamol) compared with beta 2 agonists (salbutamol) alone for the treatment of children with acute exacerbation of asthma. Methods: This is a randomized comparative study conducted in the Department of pediatrics ASRAM Medical College during the period May 2018 to June2019. Total 66 children between the age group of 1-15 years with eligible diagnostic criteria were included in the study. Results: The percentage increase in predicted PEFR is better in Group II with a mean of 24.74 compared to Group I with a mean of 13.35. The p value is highly significant 0.001. The mean PAS at the start of the study is 10.5 in Group I and 10.7 in Group II. The mean PAS at the end of the study is 7.19 in Group I and 5.77 in Group II. The p value is 0.001 and is highly significant. The outcome is better in Group II when compared to Group I with a better decrease in PAS and better increase in percentage predicted PEFR. Conclusion: In the present study it has been proven the repeated doses of Ipratropium bromide combined to Salbutamol is beneficial and it reduces the broncomotor cholinergic tone.
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Introduction: It is well documented that any sort of exercisedone regularly, is beneficial for health. Swimming is noexception and considered to be a very good exercise formaintaining proper health and also has a profound effect on thelung functions. Regular swimming practice gives a positiveeffect on the lungs by increasing the pulmonary capacity andthus improves the lung functions. The proposed study wascarried out with the above background, among swimmingbeginners undergoing a swimming training session to see howa course of swimming affect the lung function parameters.Material and Methods: The study was carried out on 32males and 12 females’ healthy young adults of either sex ofage group of 18-35 yrs. At the beginning of the swimmingsession recording of pulmonary functions tests was done foreach selected candidate (control group). Again procedureswere repeated at the end of three months and at the end of sixmonths for same candidates (case group).Results: In the present study, it is observed that there issignificant increase (p value <0.05) in FVC, FEV1, PEFR andMVV after three months and after six months of swimmingboth males and females separately.Conclusion: From the present study we concluded that evenafter short course of swimming training session there issignificant benefit in some parameters of lung function. Theimprove lungs function is thought to be duo to increase inrespiratory muscle mass. More elaborate and multi-centredstudies are needed to corroborate our findings
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Background: Being an important physiological and clinical tool in assessing respiratory conditions, it is common knowledge that Peak expiratory flow rate (PEFR) may be affected by some factors affecting the normal function of the respiratory system. Such factors include the body constitution such as height, built, sex, age etc.; The trunk-leg ratio (TLR) was used in apparently normal young adults. A better understanding of the association between Trunk-leg ratio and PEFR may identify those with elevated risk of respiratory diseases. Methods: The study was an analytical cross-sectional design, involving 83 Level 200 MBBS/BDS students of Bayero University, Kano. There were a total of 39 males and 44 females. A peak flow meter and a measuring tape to scale were used to measure the PEFR, trunk length and leg length respectively. A questionnaire was used to determine any history of cardio-respiratory disease A consent of the participants and ethical approval was obtained before the commencement of the study. Results: The males had higher PEFR value (491.79±67.19L/min) while the females had a lower PEFR of 366.82±43.28L/min and the difference was statistically significant. The males had higher values of trunk length, leg length and TLR and there was no significant different between that male and female trunk length ratio. There was A significant correlation between PEFR and leg length indicating that the longer the leg length, the higher the PEFR. Conclusion and Recommendation: Significant correlation was found between the TLR, which is an anthropometric parameter and the PEFR which is an important diagnostic tool in determination of some types of respiratory diseases. This relationship signifies that the taller the person, irrespective of the trunk length, the higher the PEFR. It is recommended that further studies should be explored involving other anthropometric parameters like trunk-leg volume in future studies.
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Background: This study has been performed to compare the pulmonary functions of healthy adolescents studying in schools situated in highly polluted areas with those studying in schools of low polluted areas of south western Punjab.Methods: This study was conducted in various schools located at Faridkot and Bathinda city. These places had been identified by the Punjab Pollution Control Board (PPCB) as having low and high air pollution levels respectively. Study Population divided into two groups that is Group A: 300 children from schools situated in Bathinda city. Group B:' 301 children from schools situated in Faridkot city. Spiro Excel spirometer was used, and following parameters were obtained: FVC, FEV?, FEV?% (relation of FEV? to FVC), PEFR, FEF25-75%. Results: FVC was low in males and females in the high polluted group as compared in the low polluted group (p = 0.042; significant; males) (p = 0.039; significant; females). FEV? was low in males and females in high polluted group as compared in low polluted group (p = 0.003; significant; males) (p = 0.026; significant; females). In this study only, males showed a significant fall in mean percentage of FEF25-75%. PEFR was low in males in high polluted group as compared to that in low polluted group (p = 0.007; significant) while in females it was insignificant.Conclusions: It is concluded that in South Western Punjab, air pollution has detrimental effect on pulmonary functions (FVC, FEV?, FEV?%, FEF25-75% and PEFR) in healthy adolescents.
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Background: Peak expiratory flow rate is the simplest , cost effective and easily available test to assess the respiratory function. PEFR is measured by a peak expiratory flow meter. Measurement of PEFR is most commonly used for asthmatic patients. To evaluate the effect of lower respiratory tract infection on peak expiratory flow rate in children.'Methods: PEFR were measured in eighty children suffering from LRTI by peak flow meter . Height and weight were measured. PEFR was compared with the normal charts. mean PEFR was calculated and predicted percentage of PEFR was calculated.Results: Mean PEFR in pneumonia , para pneumonic effusion, bronchiectasis, and bronchitis was 187.2 , 187.6, 171.85 and 173.1 respectively. Mean PEFR was maximally reduced in bronchiectasis and bronchitis. Mean' PEFR was reduced in female children in comparison to males with LRTI. PEFR was decreased' more in children with severe clinical presentation and with malnutrition.Conclusions: In this study , most common LRTI was pneumonia followed by parapneumonic effusion. PEFR was maximally reduced in bronchiectasis and bronchitis. Undernourished children were more affected.
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Introduction: Management of common bile duct stones(CBDS) presents a surgical challenge since it is the majorcause of hepatobiliary morbidity and complications. The aimof the study was to evaluate the best line of treatment for CBDstone and complications related to every approach.Material and Methods: This retrospective study includespatients with CBDS who were treated with conservativetreatment or endoscopic stone extraction followed bylaparoscopic cholecystectomy (LC). Primary outcome wassuccessful clearance of common bile duct and secondaryoutcomes were complications, total cost and hospital stay.Results: Out of 25 patients, 13 were treated by ERCP(Endoscopic Retrograde Cholangio Pancreatography) and12 by Conservative approach. There was complete clearanceof CBDS in 10 (76%) cases out of 13, in the endoscopicretrograde cholangiopancreatography (ERCP) group and inthe remaining 3 patients, the Common bile duct stone wasremoved by the trans-cystic exploration. In the conservativegroup, there was complete clearance of CBDS in 8 (66%)cases, and in the remaining 4 (33%)patients, the common bileduct stone was removed by the transcystic exploration.Conclusion: Management of CBDS represents a surgicalchallenge. CBDS increases the technical difficulty of ERCPand increases the risk of PEP. Conservative managementof CBDS avoids the risks associated with ERCP and isalso effective in clearing CBDS so one should consider aconservative line of treatment in CBDS in order to decreasethe cost and avoid unnecessary ERCP.
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Introduction: Tobacco smoking is a major risk factor for various respiratory diseases in humans PEFR is a useful parameter to monitor airway obstruction, its severity, variation and evaluation of treatment Aim of the study: The aim of this study was to assess the PEFR in age-matched asymptomatic smokers and non-smokers Materials and methods: Study was conducted in 50 asymptomatic smokers and 50 healthy nonsmokers PEFR recording was done using Wright’s peak flow meter Results: On comparing the anthropometric indices, mean weight of the smokers was 6123 whereas it was 6688 in nonsmokers which was statistically significant Mean PEFR of smokers was 35416 and that of nonsmokers was 40960 which were significant Smokers smoking for less than 10 years had a mean PEFR of 368 as against the PEFR of 308 in those with smoking history for more than 10 years Beedi smokers had the lowest mean PEFR of 2565 when compared to cigarette smokers mean PEFR of 35260 Conclusions: Smoking had a significant impact on the lung function of smokers even though they are asymptomatic Smokers had a significant reduction in their weight too Smoking for a longer duration of years affects both cigarette and beedi smokers but the worst was with the Beedi smokers PEFR is an easy and effective method of detecting deterioration in lung function in OPD setting thus helping to create awareness among smokers to quit smoking as early as possible
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Background and Objectives: Type II diabetes mellitus (DM) is particularly common medical disorder and is leading cause of morbidity worldwide. The complication of DM is due to micro or macro vascular damage. The presence of an extensive microvascular circulation and abundant connective tissue in the lungs raises the possibility that lung tissue may be a target organ in diabetic patients and thus pulmonary function test can be affected by DM. This study was designed to compare pulmonary function test between Type II diabetic and non-diabetic individuals; and, with the duration of DM.Material and Methods: This cross sectional comparative study was conducted at King Edward Medical University, Lahore Pakistan. Total sample consist of 91 diabetic and 91 non-diabetic grouped as group A and group B. FEV1, FVC, FEV1/FVC ratio, and PEFR were compared within two groups and with the duration of DM.Results: Total 182 sample with mean age 53.1±5.90 years, with 91(50%) male and 91(50%) female. Group A and B had 91(50%) sample each. Mean value of FVC, FEV1 and PEFR showed statistically significant difference among the both group. Mean of FVC decreases significantly with the increasing duration of DM; although, is not significant with FEV1, FEV1/FVC ratio, and PEFR.Conclusion: Diabetic group showed significantly impaired pulmonary functions test as FEV1, FVC, and PEFR as compare to non-diabetic group.
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Background: Pregnancy is a physiological state causing significant physical and functional changes in Cardiovascular and Respiratory system. It is important to recognize the adaptive changes during pregnancy in order to identify and manage Respiratory impairment. The Respiratory system undergoes structural and functional alterations affecting the thoracic cage, abdominal cavity and diaphragm. There is a decrease in Functional Residual Capacity (FRC), Expiratory Reserve Volume (ERV), Chest wall Compliance & increases in Tidal Volume (TV), Minute Ventilation (MV) during pregnancy. However, Airway function is postulated to largely remain unchanged during pregnancy with Peak Expiratory Flow Rate (PEFR), FVC and Forced Expiratory Rates like FEV1 showing little change. Hence, PEFR which is a simple, portable, cheap and reproducible parameter can be utilized to assess airway function during pregnancy. Due to conflicting reports of PEFR with advancing gestation in different ethnic groups and limited studies in the South Indian population, the present study was undertaken to evaluate the PEFR variation in different trimesters of normal pregnancy. Aim: To Evaluate the Peak Expiratory Flow Rate in Pregnancy in different trimesters. Aruna Shanmuganathan, Krishnaveni R, Meenakshi Narasimhan, Viswambhar V, Ragulan R, Nisha Ganga, Gangaiamaran M, SSJ Shiek Fareeth Ahmed. Evaluation of Peak Expiratory Flow Rate in Pregnancy in a South Indian Tertiary Care Centre. IAIM, 2017; 4(7): 61-66. Page 62 Materials and methods: Total of 165 pregnant women in the age group of 20-35 year with no respiratory illness or co morbidities (55 in each trimester) were included in our study. Control group consisted of 55 age and height matched non pregnant women. Informed consent was obtained and PEFR was performed using Mini Wright s Peak Flow Meter and best of three recordings noted. Data analyzed using SPSS package version 21.0. Association between PEFR with Age and BMI performed using Pearson correlation. The Bonferroni’s Multiple Comparison Test executed to determine the significant variance of PEFR between control and study groups. Results: PEFR was significantly lower in all trimesters of pregnancy compared to controls. However, there was no significant difference in PEFR across trimesters. Age and BMI did not correlate with PEFR. Conclusions: PEFR was significantly lower in all trimesters compared to controls. Hence, prospective Indian studies with larger samples are needed to arrive at Normograms for PEFR in each trimester of normal pregnancy which would enable us to use PEFR as a simple tool to assess airway obstruction in pregnancy.
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Background: Obesity has become one of the major health issues in India. WHO defines obesity as “A condition with excessive fat accumulation in the body to the extent that the health and wellbeing are adversely affected”. Obesity results from a complex interaction of genetic, behavioral, environmental and socioeconomic factors causing an imbalance in energy production and expenditure. Peak expiratory flow rate is the maximum rate of airflow that can be generated during forced expiratory manoeuvre starting from total lung capacity. The simplicity of the method is its main advantage. It is measured by using a standard Wright Peak Flow Meter or mini Wright Meter. Aim: The aim of the study is to see the effect of body mass index on Peak Expiratory Flow Rate values in young adults. Materials and methods: A correlational study was done 40 healthy individuals with age of 18-35 year old. Subjects having cardio or pulmonary condition were excluded. Then according to body mass index (BMI) normal (group A) and obese (group B) individuals were included. Where, BMI - normal: 18.5-22.9 kg/m2 and obese: 25 kg/m2 onwards. Then in sitting position all the individuals were given three trials for PEFR and best of all was taken. Results: Group A: BMI mean -18.74±1.11and PEFR mean - 395±116.8, Group B: BMI mean - 28.7±1.12 and PEFR mean - 309±46.4. According to spearman’s correlation Group A, r= 0.456 and p=0.022 also in Group B r=0.097 and p=0.342. Conclusion: There was weak correlation in between BMI and PEFR.
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Introduction: The diaphragm is man's main respiratory muscle. The role of the abdominal muscles is seen in both quiet and forceful breathing. Abdominal muscle function could be affected in subjects with back pain. Few studies are done about the relation between expiratory muscle strength and pulmonary function. So the aim of this study was to evaluate the correlation of abdominal muscle strength with pulmonary function in patients with low back pain. Materials and methods: Sixty subjects with low back pain were included in the study. Subjects with history of acute or chronic respiratory disorders were excluded. Abdominal muscle strength was measured by curl up test and FEV1/FVC and peak expiratory flow rate (PEFR) was measured to assess pulmonary functional. Results: Using Spearman test for correlation between abdominal muscle strength and FEV1/FVC (r= - 0.27, p=0.03), and between abdominal muscle strength and PEFR (r=0.34, p=0.007) was seen. Conclusion: There was a weak correlation between abdominal muscle strength and pulmonary function in subjects of low back pain.
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Background: Body and mind work perfectly after yoga. To find out the effect of yoga (pranayama) on respiratory parameter a cross sectional study was conducted. Methods: Subjects selected are people (male and female) aged from 50-70 year without any active medical complain. Study is conducted in RMCH Bareilly U.P. Results: Respiratory parameters measured are FVC, FEV1, ratio of FVC/FEV1 and PEFR. These parameters are taken before and after 12 week of pranayama. Conclusion: 12 weeks of regular yogic training in elderly individuals showed definite improvement in their ventilatory functions, as observed from improvement in their FVC, FEV1 FEV1/FVC RATIO and PEFR.
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Backgrounds And Objectives: Tobacco consumption in different forms is a common addiction in the socio-economically handicapped population in many developing countries there are few data on the uantitative effects of cigarette smoking on lung function in young adults. These effects are important in the understanding of the early stages of chronic airflow obstruction. Material and method: Our study was performed on a total of 100 subjects (50 control and 50 were cigarette smokers) with the age group between 15-40 years were selected. Smokers were categorized into mild, moderate and severe smokers on the basis of number of cigarette smoke per day. Computerised spirometery examination was performed on both control and smokers. Results and Interpretation: We observed an inverse dose–response relation between smoking and FEV1, FVC, FEV1/FVC, PEFR; FEF etc. severe smokers had a low FEV1, PEFR, and FVC than control group. Conclusion: Cigarette smoking has a dose related adverse effect on the evolution of ventilatory lung function in young adulthood. Cigarette smoking is associated with evidence of airway obstruction and slowed growth of lung function in adults, exposure to cigarette smoke led to a greater increase in the number of mucus- producing tracheal goblet cells that enhanced the airway obstruction that may be the cause for decline in the lung functions.
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Background: Systemic Lupus Erythematosus (SLE) is an autoimmune disorder which affects multiple organs of human including lungs. Objectives: To assess PEFR and FEF25-75 in SLE patients and to correlate them with the duration of the disease. Method: This cross-sectional study was carried out in the Department of Physiology, BSMMU, Dhaka, from January 2010 to December 2010. A total number of 120 female subjects were selected, among which 30 were age and BMI matched apparently healthy subjects for comparison (control) and 90 were patients of SLE (study group). All the patients were matched for age, sex and BMI. Based on the duration of the disease, patients were subdivided into B1 (1-6 months), B2 (2-5 years) and B3 (6-10 years). Controls were selected from the community and the patients from the Out Patient Department (OPD) of SLE clinic, Department of Medicine, BSMMU, Dhaka. (PEFR) and FEF25-75 of all the subjects were measured by a Digital MicroDL spirometer. For statistical analysis Independent Sample ‘t’ test, One way ANOVA test and Pearson’s correlation coefficient test were performed as applicable. Results: The mean percentage of predicted values of lung function parameters in healthy female subjects were within normal ranges. The mean percentage of predicted values of PEFR and FEF25-75 were significantly lower in all study groups when compared to control. Again, the mean percentage of predicted values of PEFR and FEF25-75 were significantly lower in the patients of Group B3 compared to Group B2. Moreover, these comparisons were significantly lower when compared to Group B1. The differences of the mean percentage of predicted value of PEFR, FEF25-75 were non-significantly lower in Group B2 when compare to Group B1. In addition, FEF25-75 were positively correlated with duration of SLE in group B2 but negatively correlated in B3. On the other hand PEFR was negatively correlated with duration of SLE in both B2 and B3. All these values were statistically non-significant. Conclusion: These pulmonary functions decrease in SLE female and the reduction is inconsistently associated with duration of the disease.
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Asthma attacks are serious respiratory problem that can be lethal when not treated appropriately. Till today the main stay of therapy is short acting ß2-agonist. Unfortunately in acute asthma episodes this is not enough to relieve the bronchospasm and reduce dyspnea. The shortcoming of ß2-agonist therapy has resulted in the use of a variety of other treatment in the management of acute asthma. The use of magnesium sulphate is one of the recent treatment options. This study was done to compare the efficacy of nebulized salbutamol with magnesium sulphate versus salbutamol with normal saline in the treatment of acute exacerbation of asthma in children. This randomized controlled trial was carried out among 60 patients with acute exacerbation of bronchial asthma fulfilling the inclusion criteria, admitted in the department of Paediatrics, Mymensingh Medical College Hospital over a period of one year from January 2009 to December 2009. They were distributed randomly, 30 patients received nebulized salbutamol (0.15mg/kg; minimum dose 2.5mg) with 2.0 ml of isotonic magnesium sulphate solution and another 30 patients received the same dose of salbutamol with 2.0 ml of normal saline on 3 occasions at 20 minute intervals. With single dose of nebulization in the magnesium sulphate with salbutamol group, by 20 minute almost all 26 (86.7%) patients achieved at least 60% of predicted PEFR. Within 20 minute from control group none could achieve 60% of predicted PEFR. After second dose of nebulization control group started achieving 60% of predicted value. Regarding response criteria, with second dose of nebulization, at 40 minute 16 (53.3%) patient from magnesium sulphate with salbutamol group showed good response (PEFR>70% predicted). But within the first 40 minutes, none could show good response in control group. With 3rd dose of nebulization all from magnesium sulphate group showed good response but even at 60 minute, 5 (16.7%) patients in control group failed to be included as good responder. In conclusion, nebulization by isotonic magnesium sulphate solution with salbutamol provide early and better response as compared to conventional approach (salbutamol plus normal saline) in acute exacerbation of asthma in children.