Dose equivalence of drugs for asthma.

which suggests that these tumours may be difficult to palpate.We were alarmed at the proportion of cases of pyloric stenosis in Macdessi and Oates's study in which clinical diagnosis was preceded by imaging (31% during 1988-91).Surely the practice in most paediatric units is to emphasise to students and juniors that pyloric stenosis should be diagnosed clinically, with imaging being reserved for difficult diagnoses.The number of barium examinations performed was just as alarming, and we question why these were performed.In our study no barium examinations were required to make the diagnosis.Finally, ultrasound imaging should be performed at the cotside immediately after the abdominal examination.Our policy is to perform both these assessments together to make a rapid diagnosis in the presence of the parents and hence alleviate parental anxieties.Over the years we have found that our juniors' ability to palpate pyloric tumours has improved as they are disappointed if the ultrasound scan proves them wrong.