MAPK/ERK signalling mediates VEGF-induced bone marrow stem cell differentiation into endothelial cell

Multi-potent adult progenitor cells (MAPCs) differentiate into endothelial cells (ECs) in the presence of vascular endothelial growth factor (VEGF). The mechanism(s) of VEGF-induced differentiation of MAPCs to ECs are not yet known. We, therefore, examined the role of mitogen-activated protein kinase/extracellular signal-regulated kinase (p42/44-MAPK/ERK1/2) signalling in endothelial differentiation from bone marrow stem cells. We observed that VEGF stimulation of MAPCs for 14 days results in a significant expression of endothelial-specific gene and/or proteins including von Willebrand factor (vWF), vascular endothelial-cadherin (VE-cadherin), VEGF receptor-2 (VEGFR2), and CD31. Up-regulation of EC-specific markers was accompanied by a cobblestone morphology, expression of endothelial nitric oxide synthase (eNOS), and Dil-Ac-LDL uptake, typical for EC morphology and function. VEGF induced a sustained activation of p42 MAPK/ERK, but not that of p44 MAPK/ERK during the course of MAPCs differentiation in a time-dependent manner up to 14 days. VEGF-induced activation of p42 MAPK/ERK also led to the nuclear translocation of MAPK/ERK1/2. Incubation of MAPCs with MAPK/ERK1/2 phosphorylation inhibitor PD98059 blocked the sustained VEGF-induced MAPK/ERK1/2 phosphorylation as well as its nuclear translocation in the differentiating MAPCs. Inhibition of MAPK/ERK1/2 phosphorylation by PD98059 also blocked the expression of EC-specific genes in these cells and their differentiation to ECs. These data suggest that VEGF induces MAPC differentiation into EC via a. MAPK/ERK1/2 signalling pathway-mediated mechanism in vitro.

A comparative emission profile of an urban area in Madhya Pradesh, India

This paper emphasizes on mathematical and field work approach to diagnosing the environmental pollution for Indore, India. These applications are based on the time-series statistics and for three semi-industrial as well as residential areas. The generalized additive models finds as a best fit-model in terms of autocorrelation and reduction of over-dispersion. The interdisciplinary study works on the principal of pollutant source, meteorological parameters, pollutant types, emission rates and various chemical processes. Several chemical or industrial processes like iron and steel production, combustion of fossil fuels, biomass burning, thermal power plants are major polluter in most of the mega cities.

Antimicrobial activity of leaf extract of Basilicum polystachyon (L) Moench

Phenolic extract of leaves of Basilicum polystachyon (L) Moench was tested for in vitro antimicrobial activity against five bacteria (Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, Bacillus subtilis, Micrococcus leuteus) and three fungi (Fusarium oxysporum, Aspergillus niger, Helminthosporium oryzae). Efficacy of organic solvents, methanol and ethanol, as agents for extraction was compared with acidic water (2M; HCl). High-pressure liquid chromatographic (HPLC) data showed that acidic extraction (2M; HCl) resulted in higher yield of caffeic acid (0.437 mg g(-1)) and rosmarinic acid (0.919 mg g(-1)). Acidic extract showed high activity against Gram (+) ve bacteria, but was less active against Gram (-) ve bacteria. Amongst the tested fungi, maximum activity was exhibited against Aspergillus niger. This is the first report on the phenolic constituents and bioactivity of B. polystachyon.

Cranberry products inhibit adherence of p-fimbriated Escherichia coli to primary cultured bladder and vaginal epithelial cells

PURPOSE

Cranberry proanthocyanidins have been identified as possible inhibitors of Escherichia coli adherence to uroepithelial cells. However, little is known about the dose range of this effect. Furthermore, it has not been studied directly in the urogenital system. To address these issues we tested the effect of a cranberry powder and proanthocyanidin extract on adherence of a P-fimbriated uropathogenic E. coli isolate to 2 new urogenital model systems, namely primary cultured bladder epithelial cells and vaginal epithelial cells.

MATERIALS AND METHODS

E. coli IA2 was pre-incubated with a commercially available cranberry powder (9 mg proanthocyanidin per gm) or with increasing concentrations of proanthocyanidin extract. Adherence of E. coli IA2 to primary cultured bladder epithelial cells or vaginal epithelial cells was measured before and after exposure to these products.

RESULTS

Cranberry powder decreased mean adherence of E. coli IA2 to vaginal epithelial cells from 18.6 to 1.8 bacteria per cell (p <0.001). Mean adherence of E. coli to primary cultured bladder epithelial cells was decreased by exposure to 50 mug/ml proanthocyanidin extract from 6.9 to 1.6 bacteria per cell (p <0.001). Inhibition of adherence of E. coli by proanthocyanidin extract occurred in linear, dose dependent fashion over a proanthocyanidin concentration range of 75 to 5 mug/ml.

CONCLUSIONS

Cranberry products can inhibit E. coli adherence to biologically relevant model systems of primary cultured bladder and vaginal epithelial cells. This effect occurs in a dose dependent relationship. These findings provide further mechanistic evidence and biological plausibility for the role of cranberry products for preventing urinary tract infection.

Impact of cadmium and lead on Catharanthus roseus--a phytoremediation study

The Madagascar Periwinkle, Catharanthus roseus (L.) G. Don (a valued medicinal plant) was exposed to different concentrations ofheavymetals like, CdCl, and PbCl, with a view to observe their bioaccumulation efficiency. Germination was inhibited by both the heavy metals in the seeds previously imbibed in GA, and KNO, for 24 hr. EC50 (the effective concentration which inhibits root length by 50%) was recorded as 180 microM for CdCl2, and 50 microM for PbCl2. Both alpha-amylase and protease activity were reduced substantially on treatment of seeds with increasing concentrations of CdCl2, and PbCl2. Malondialdehyde (MDA) a product of lipoxigenase (LOX) activity also increased due to the treatment of both CdCl, and PbCl2. When two-months-old plants grown in normal soil were transferred to soils containing increasing amounts of these two heavy metals, senescence of lower leaves and extensive chlorosis were noticed after four days of transfer However, plants gradually acclimatized and after 20 days the chlorophyll content was almost comparable to normal. Plants receiving CdCl2 treatment (250 microg g(-1) and less) became acclimatized after two weeks and started normal growth. But PbCl2 of 432 microg g(-1) and less could not affect the plant growth throughout, after a preliminary shock was erased. In case of CdCl2 treatment, a stunted growth with reduced leaf area, reduced biomass and sterility were recorded after six months, while plants show normal growth and flowering in case of PbCl2 treatment. Total alkaloid was also found to be decreased in the roots of CdCl2 treated plants. No change was observed in case of PbCl2. GA3 treatments to the CdCl2 treated plants show internode elongation and increase in leaf area with relatively elongated leaves and thinning of stem diameter AAS analyses of leaves of treated plants exhibited 5-10% accumulation of cadmium, but there was no accumulation of lead at all.

A comparative study of air pollution in Indian cities

Rapid and unplanned industrialization and urbanization has resulted in the deterioration of India's air quality according to air-quality monitoring carried out in seven major Indian cities in industrial and residential areas between 1995 and 2000. Suspended particulate matter (SPM) levels in Indian cities are in the range 50 to 550 microg/m(3). NO(x) values are high in Delhi's residential areas, with values of 33 microg/m(3) in 1995 and 34.6 microg/m(3) in 2000, while in an industrial area values of 29.4 microg/m(3) were found in 1995, increasing to 33.7 microg/m(3) in 2000. SO(2) values are very high in Pune city, ranging from 43.3 microg/m(3) in residential to 43.69 microg/m(3) in an industrial area in 2000.

Emergency thoracotomy after cardiac arrest from blunt trauma is not always futile

We report a case of blunt trauma leading to pulseless electrical activity (PEA) cardiac arrest that was successfully managed with emergency department thoracotomy. While the literature suggests an almost universally poor outcome from this clinical situation, in this case the patient survived with full neurological recovery. Several factors were present in this case, which have been reported as indicating an increased chance of good outcome. These were an arrest rhythm of sinus-based PEA, non-dilated reactive pupils and a short period of cardiopulmonary resuscitation. The case illustrates that in certain circumstances, emergency thoracotomy may not be futile after blunt trauma causing cardiac arrest.

Non-conventional uses of the Aintree Intubating Catheter in management of the difficult airway

We present 14 cases, of which three have been previously reported, in which non-conventional use was made of the Aintree Intubating Catheter (AIC). In seven cases the AIC was used via a ProSeal Laryngeal mask airway (PLMA). Two patients had anticipated difficult intubation, two unexpected difficult intubation and two required rescue of an obstructed airway prior to AIC-assisted intubation. In two cases of tracheal stenosis the AIC was used as a 'long narrow tracheal tube' during fibre-optic intubation: the AIC facilitated passage through the narrowed trachea and smooth railroading of a tracheal tube. In two cases the AIC was used in an awake patient. In three cases the AIC was used successfully despite gross laryngeal oedema. In three cases attempted AIC deployment failed: two patients had undergone radiotherapy to the mouth and PLMA placement failed; in the third, supraglottic oedema prevented visualisation of the larynx. The AIC via an LMA Classic was successful in one of these cases. In all cases where the larynx was visualised the AIC was rapidly successful without complications. In eight cases the anaesthetist had no experience of the technique outside workshops. These cases demonstrate general utility of the technique and successful use of the AIC via the PLMA, in awake patients, as an adjunct to fibre-optic intubation and in patients with an oedematous larynx. Finally, cases where the combination of the PLMA and AIC was unsuccessful demonstrate the technique, like many, is not always successful.

The role of magnesium as an adjuvant during general anaesthesia

Magnesium sulphate is used extensively in the treatment of eclampsia, and is also used to treat refractory arrhythmias, asthma, myocardial ischaemia and acute respiratory failure. We studied the interaction between magnesium sulphate and the anaesthetic agents propofol, rocuronium bromide and fentanyl citrate. This randomised, double blind study was conducted in 50 patients. The magnesium group A (n = 25) received 30 mg x kg(-1) magnesium sulphate before induction of anaesthesia and 10 mg x kg(-1) continuously intra-operatively until the end of surgery. Group B (n = 25) received the same volume of isotonic saline. Propofol, rocuronium and fentanyl infusions were started and the patients lungs' were ventilated with 33% oxygen in nitrous oxide. Anaesthetic depth was maintained at a bispectral index value of between 40 and 60. Muscle relaxation was maintained at a train-of-four count of 1 throughout surgery using neuromuscular monitoring. The fentanyl infusion was titrated to haemodynamic variables: heart rate and blood pressure. We concluded that magnesium sulphate has anaesthetic, analgesic and muscle relaxation effects and significantly reduces the drug requirements of propofol, rocuronium and fentanyl during anaesthesia.

A case of ovarian metastasis of gall bladder carcinoma simulating primary ovarian neoplasm: diagnostic pitfalls and review of literature

The ovary is a relatively frequent site of metastases from malignant neoplasia arising elsewhere in the body, the majority of these originating from the gastrointestinal tract. The best-known tumor of this type is signet ring cell adenocarcinoma (Krukenberg tumor) of gastric origin and large bowel. The gall bladder and bile ducts are extremely rare sources of these metastases. The casuistic describes a female patient, presented with pelvic mass and jaundice. While clinical and imaging results suggested a primary ovarian carcinoma with incidental cholelithiasis and choledocholithiasis, the final diagnosis was obtained on the basis of histopathologic findings of resected specimen.

Parotid TB

TB of the parotid is rare and only about 100 cases have been reported in the world literature. Often the diagnosis is made only after the surgery performed for a suspected neoplasm. We describe three patients with diffuse form of parotidTB without any evidence of tubercular focus elsewhere. Fine needle aspiration cytology confirmed the diagnosis in two cases, while the third case was diagnosed only after surgery.

Development of a fluorescence assay for the detection of L-ficolin-MASP in serum or purified samples

A fluorescence assay for the detection of L-ficolin-MASP in human serum or purified sample was developed by measuring the cleavage of fluorescent amide substrate by L-ficolin associated MASPs bound to the lipoteichoic acid (LTA). LTA (Staphylococcus aureus DSM 20233) was coated on NuncMaxisorp microtiter plates and serum or purified sample incubated overnight at 4 degrees C to allow the L-ficolin-MASP to bind LTA. Assay conditions for binding and complete cleavage of fluorescent amide substrate were standardized. The optimum temperature, incubation time and molarity of NaCl for LTA-ficolin binding were found to be 4 degrees C for 6 h at 1 M NaCl concentration. The optimum incubation time and pH for complete cleavage of fluorescent amide substrate by LTA bound L-ficolin associated MASP were found to be 2 h at pH 8.5. LTA-ficolin binding was found to be highly specific and was inhibited completely by LTA but not with mannose. A calibration curve was prepared by using the purified ficolin-MASP complex (1 to 12 mug/ml) and could be used to find concentration of ficolin-MASP complex in normal human serum.

Ischaemic necrosis of subcutaneous colonic neoesophagus: an unusual complication of presternal hypertrophic scar

Hypertrophic scars and keloids not only pose aesthetic problems but also cause functional and anatomical dysfunction by leading to contractures and sometimes by compression of underneath structures. A 76-year-old man presented with progressive dysphagia of two months duration. Examination showed the unusual complication of a presternal hypertrophic scar, causing ischaemic necrosis of a subcutaneously-transposed colon, used for oesophageal reconstruction in a patient with inoperable carcinoma of the oesophagus. Such a complication of hypertrophic scar has never been reported in the literature.

A case of ovarian metastasis of gall bladder carcinoma simulating primary ovarian neoplasm: diagnostic pitfalls and review of literature

The ovary is a relatively frequent site of metastases from malignant neoplasia arising elsewhere in the body, the majority of these originating from the gastrointestinal tract. The best-known tumor of this type is signet ring cell adenocarcinoma (Krukenberg tumor) of gastric origin and large bowel. The gall bladder and bile ducts are extremely rare sources of these metastases. The casuistic describes a female patient, presented with pelvic mass and jaundice. While clinical and imaging results suggested a primary ovarian carcinoma with incidental cholelithiasis and choledocholithiasis, the final diagnosis was obtained on the basis of histopathologic findings of resected specimen.

A Rare Case of Odontogenic Myxoma in a Dog

A case of odontogenic myxoma in an old Doberman bitch involving the periodontal region of the mandible was recorded. Grossly, the tumour mass was soft and slimy, having brownish-black foci on cut surface. Histopathologically, the tumour predominantly consisted of mesenchyme-like cells with prominent nuclei and nucleoli. The tumour had abundant ground substance, rich in acid mucopolysaccharides.

Angiogenesis: a curse or cure?

Angiogenesis, the growth of new blood vessels is essential during fetal development, female reproductive cycle, and tissue repair. In contrast, uncontrolled angiogenesis promotes the neoplastic disease and retinopathies, while inadequate angiogenesis can lead to coronary artery disease. A balance between pro-angiogenic and antiangiogenic growth factors and cytokines tightly controls angiogenesis. Considerable progress has been made in identifying these molecular components to develop angiogenesis based treatments. One of the most specific and critical regulators of angiogenesis is vascular endothelial growth factor (VEGF), which regulates endothelial proliferation, permeability, and survival. Several VEGF based treatments including anti-VEGF and anti-VEGF receptor antibodies/agents are in clinical trials along with several other antiangiogenic treatments. While bevacizumab (anti-VEGF antibody) has been approved for clinical use in colorectal cancer, the side effects of antiangiogenic treatment still remain a challenge. The pros and cons of angiogenesis based treatment are discussed.

Macroinvertebrates as indicators of pollution

Various pollution indicators of stream Ban-Ganga have been identified on the basis of presence/absence/numerical abundance at various stations. They have been categorized as pollution tolerant, facultative and pollution intolerant groups in relation with the water quality at different stations of stream.

More 'cries from the joints': assessment of the musculoskeletal system is poorly documented in routine paediatric clerking

OBJECTIVES

The aim of this study was to describe the assessment of the musculoskeletal (MSK) system in comparison with other systems in routine paediatric medical clerking. Furthermore, to survey trainee paediatricians (SPRs, specialist registrars) about their self-rated confidence in assessing the MSK system.

METHODS

Case notes of consecutive general paediatric medical patients admitted to three UK hospitals over a 4-week period were assessed using a standard pro forma. All patients had been assessed by a consultant paediatrician during their admission. A postal questionnaire was sent to all SPRs in training in each of the hospitals, regarding their confidence in assessing the MSK system compared with other systems and their exposure to MSK teaching.

RESULTS

Case notes of 257 patients [117 females, median age 3 yr (range 1-18 yr)] were reviewed. The most common reason for admission was acute infection, although the spectrum of other recorded diagnoses varied between hospitals. Thirteen children (5%) had an acute problem (e.g. infection) against a background of chronic disease. The case note documentation showed that cardiovascular (CVS), respiratory (RS) and gastrointestinal (GI) systems were assessed in the vast majority (>90%) of patients, irrespective of the underlying diagnosis. However, other systems were less well recorded; the trend being the same in each hospital and in descending order, the neurological system (38%), skin (32%), eyes (10%) and musculoskeletal system (4%). Only 2.7% (7/257) patients were documented to have been asked about MSK symptoms, and only 1.6% (4/257) had any documentation of joint examination--in all cases this was limited (e.g. range of movement of the knee only), and no patients had documentation of gait being examined, even in those children presenting with 'limp'. The response rate to the postal questionnaire was 60% (67/112). The self-rated confidence in MSK assessment was markedly low in comparison with other systems, even though 61/67 recalled some teaching of the MSK system as an undergraduate (61/67) or postgraduate (50/67). Of note none could recall teaching as an undergraduate in paediatric MSK assessment and where there had been postgraduate rheumatology MSK teaching this had been delivered by paediatric rheumatologists in many cases (34/50), reflecting the centres participating in the study.

CONCLUSIONS

In routine general paediatric medical in-patient clerking and throughout the admission, MSK assessment was rarely documented, and even where present was limited. This contrasts markedly with other systems which were examined in most children irrespective of the presenting complaint. Self-rated confidence in MSK assessment is low amongst SPRs compared with other systems, despite most recalling some teaching. This discrepancy between teaching and clinical practice needs to be addressed in undergraduate and postgraduate training.

A thyroid tubercular abscess and bilateral symmetrical hilar lymphadenopathy: a rare association

An 18-year-old boy presented with a rare association of a thyroid tubercular abscess and bilateral symmetrical hilar lymphadenopathy. He was put on a Category I regimen with standard short course daily chemotherapy of four anti-tubercular drugs under the National Tuberculosis Programme. After a six-month of anti-tubercular treatment (ATT), the boy showed clinical and bacteriological improvement. The thyroid scan with Technetium 99 (Tc 99) and the chest skiagram also became normal.

Effect of single inhalation of a salbutamol, ipratropium bromide and beclomethasone on mucociliary clearance in patients with chronic obstructive airway disease

BACKGROUND

Chronic obstructive airway disease (COAD) is associated with hyperplasia and hypertrophy of the mucus producing glands. The beneficial effect of inhaled drug may be due to improved mucociliary function. The present study was done to evaluate the effect of salbutamol, ipratropium bromide and beclomethasone dipropionate inhalation on mucociliary clearance in patients with COAD.

METHODS

Ten patients of COAD were taken up, two patients however did not complete the study. Salbutamol, ipratropium bromide, beclomethasone dipropionate and placebo inhalation were given randomly to each patient on four separate days. Radioaerosol inhalation lung cine-scintigraphy after inhalation of the different drugs was followed up to two hours and than after 24 hours.

RESULTS

There was no significant visually noticeable increased mucociliary clearance on any of the days. Two patients showed definite steep slope in the time activity curves with salbutamol as compared to other drugs or placebo. All the quantitative indices analysed at the end of one hour and two hours for the three drugs were comparable to placebo.

CONCLUSIONS

A single dose of inhaled salbutamol, ipratropium bromide and beclomethasone dipropionate has no appreciable effect on mucociliary clearance in patients with COAD.

Binding and displacement of vascular endothelial growth factor (VEGF) by thrombospondin: effect on human microvascular endothelial cell proliferation and angiogenesis

Vascular endothelial growth factor (VEGF) is a specific angiogenic factor, and thrombospondin (TSP), is a potent inhibitor of angiogenesis. To better understand the role of TSP as an anti-angiogenic agent, we have identified its specific domains that participate in its anti-angiogenic activity and examined the mechanism of its inhibitory effect on VEGF(165) induced angiogenesis. Exogenously added TSP inhibited VEGF(165) induced angiogenesis (proliferation and tube formation of human dermal microvascular endothelial cells [HDMEC] and neovascular outgrowth from human arterial rings). Although both VEGF(165) and TSP are heparin binding proteins, TSP had a higher affinity for (125)I-heparin than VEGF(165) (K(d1) 4 nM and K(d2) 14 nM for TSP; K(d) 91 nM for VEGF(165)). TSP displaced 36% of (125)I-VEGF(165) from HDMEC and this was comparable to the 27% reduction in (125)I-VEGF(165) binding to HDMEC upon cleavage of cell surface heparan sulfate (HS). About 35% of the mitogenic activity of VEGF(165) was attributable to its heparin binding region. These results indicate that a proportion of the mitogenic activity of VEGF(165) is inhibited by TSP via competition for cell surface HS. Further, (125)I-VEGF(165) bound directly to TSP in a saturable, concentration dependent manner, and heparin modulated this binding. The mAbs to the heparin binding domain to the type 1 and type 3 repeats of TSP inhibited the binding of VEGF(165) to TSP, and also blocked the inhibitory effect of TSP on VEGF(165) induced HDMEC proliferation. We conclude that (i) the anti-angiogenic activity of TSP is localized in its heparin binding domain and type 1 and type 3 repeats (ii) TSP inhibits angiogenesis by at least two separate mechanisms, (a) displacement of VEGF(165) from endothelial cell HS and (b) direct binding to VEGF(165).

The effect of local-scale physical heterogeneity and nonlinear, rate-limited sorption/desorption on contaminant transport in porous media

Nonideal transport of contaminants in porous media has often been observed in laboratory characterization studies. It has long been recognized that multiple processes associated with both physical and chemical factors can contribute to this nonideal transport behavior. To fully understand system behavior, it is important to determine the relative contributions of these multiple factors when conducting contaminant transport and fate studies. In this study, the relative contribution of physical-heterogeneity-related processes versus those of nonlinear, rate-limited sorption/desorption to the observed nonideal transport of trichloroethene in an undisturbed aquifer core was determined through a series of miscible-displacement experiments. The results of experiments conducted using the undisturbed core, collected from a Superfund site in Tucson, AZ, were compared to those obtained from experiments conducted using the same aquifer material packed homogeneously. The results indicate that both physical and chemical factors, specifically preferential flow and associated rate-limited diffusive mass-transfer and rate-limited sorption/desorption, respectively, contributed to the nonideal behavior observed for trichloroethene transport in the undisturbed core. A successful prediction of trichloroethene transport in the undisturbed core was made employing a mathematical model incorporating multiple sources of nonideal transport, using independently determined model parameters to account for the multiple factors contributing to the nonideal transport behavior. The simulation results indicate that local-scale physical heterogeneity controlled the nonideal transport behavior of trichloroethene in the undisturbed core, and that nonlinear, rate-limited sorption/desorption were of secondary importance.

Effect of inhalation of salbutamol, beclomethasone dipropionate & ipratropium bromide on mucociliary clearance in some patients with chronic stable bronchial asthma

BACKGROUND & OBJECTIVES

Asthma is now regarded as an inflammatory disease and bronchial inflammation may disrupt mucociliary function. Inhaled drugs may act by improving mucociliary function. The aim of the study was to investigate the effect of salbutamol, ipratropium bromide and beclomethasone on mucociliary clearance in patients with chronic stable asthma and to compare the efficacy of these drugs on mucociliary clearance.

METHODS

Ten patients with chronic stable asthma were enrolled in the study, but two patients did not complete the study. Patients with bronchial asthma were chosen on clinical grounds. (99m)Tc phytate radioaerosol generated through a nebulizer, was given to each patient on four days. After each administration the radioactivity over the thorax was constantly measured in sequential frame mode for 120 min. Radioactivity in the thorax was also measured after 24 h. A base-line pulmonary function test with reversibility was obtained. Salbutamol, ipratropium bromide, beclomethasone dipropionate and placebo inhalation were given randomly to each patient on four days.

RESULTS

The mean age of patients (n = 8) was 36 +/- 9.3 yr and mean duration of symptoms was 5 +/- 6.6 yr. There was no visual impression that mucociliary clearance was enhanced with any of the drugs. The time activity curves did not show any visually recognisable change in slope. In only one patient the curve tended to show a steeper slope with ipratropium inhalation. In the rest of the patients the curves showed no difference at all with medication when compared with placebo. All the quantitative indices analyzed by two-way ANOVA at the end of one and two hours were comparable for the three test drugs and placebo. None of the three test drugs demonstrated statistically significant mucociliary clearance effect compared with placebo. However, the temporal difference in airways clearance efficiency (ACE) was significant with beclomethasone and ipratropium bromide.

INTERPRETATION & CONCLUSION

Inhalation of any of the three drugs tested did not produce any immediate improvement in mucociliary clearance as compared to placebo in patients with stable bronchial asthma suggesting the need for further studies using higher doses of drugs for longer duration in a large sample.