Sarhan 2016.

Methods	Double blind, randomised controlled trial. Chest and emergency departments at 1 hospital, Egypt.
Participants	Inclusion criteria: diagnosis of asthma. Exclusion criteria: fever, lower respiratory tract infection, cardiac/renal/hepatic dysfunction, needed NIV/intubation, near‐fatal asthma, pregnancy, lactation, failed to use PEF meter, inhaled/oral/intravenous bronchodilator use within past 6 h or steroid use within past 12 h. 30 randomised. Intervention 1 (magnesium): 10 randomised. Mean age (years): 33.5 (17.8). Men:women: 4:6. Mean % of predicted PEF at presentation: 33.9 (9.8). Intervention 2 (salbutamol and placebo) : 10 randomised. Mean age (years): 48.6 (9.9). Men:women: 3:7. Mean % of predicted PEF at presentation: 36.4 (10.5). Intervention 3 (salbutamol and magnesium): 10 randomised. Mean age (years): 51.3 (15.8). Men:women: 7:3. Mean % of predicted PEF at presentation: 34.1 (9.4).
Interventions	Intervention 1: 3 mL MgSO₄ (3.3% solution) nebulised. Intervention 2: 0.5 mL salbutamol (0.5% solution) in 2.5 mL isotonic saline nebulised. Intervention 3: 0.5 mL salbutamol (0.5% solution) in 2.5 mL MgSO₄ (4% solution) nebulised. 4 doses given at 20 minute intervals. Ultrasonic nebuliser.
Outcomes	PEF improvement, respiratory rate, heart rate, blood pressure, oxygen saturations, improvement in Fischl index of clinical severity, adverse event rate (all at "final" time point, assumed to be 2 h). Adverse events: no events "severe enough to warrant withdrawal" reported.
Notes	Funding: not reported.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Reports patients were randomised into 3 groups but no details given.
Allocation concealment (selection bias)	Unclear risk	Data not given.
Blinding of participants and personnel (performance bias) All outcomes	Unclear risk	Described as "double blind" but no details given about who was blinded or how.
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	Described as "double blind" but no details given about who was blinded or how.
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	The report does not specify how many randomised participants completed the trial.
Selective reporting (reporting bias)	Unclear risk	No prospective trial registration identified. Primary and secondary outcomes not defined. No power calculation reported.