Unusual sternal fracture 593 an irregular solid. When he stepped into the bath, he noticed water spilling over the top, and suddenly realised that the volume of the spilt water was equal to his bulk, thus, if he put the crown into water, he could find its volume. If he then put a block of pure gold the same weight as the crown into water, and the volume was the same, it would prove the crown was gold, not an alloy. According to the story, Archimedes was so excited, he jumped out the bath and ran naked through the streets of Syracuse shouting "Eureka, eureka!"-"I've found it!"

Antimicrobial Stewardship Program (ASP) has been implemented in major public hospitals in Malaysia, with pharmacists playing a key role in ensuring the appropriate use of antibiotics. This survey aimed to assess the practices, perceptions, and knowledge of public hospital pharmacists on antibiotic use and resistance. A cross-sectional survey involving pharmacists from six public hospitals in Penang was conducted using a self-administered validated questionnaire. The majority of pharmacists perceived that polypharmacy (92%, n = 270) and overuse of broad-spectrum antibiotics (85%, n = 252) can potentially induce resistance of microorganisms and that ensuring the rational use of antibiotics is a shared responsibility between clinicians and pharmacists (94%, n = 278). A large majority of the pharmacists think that formal training in infectious disease should be a pre-requisite for pharmacists in ASP (93%, n = 273). In terms of antibiotic selection, the availability of antibiotics in hospital (81%, n = 234) and patient’s clinical condition (68%, n = 196) are more of a concern to the pharmacists. A total of 65% of the respondents (n = 192) demonstrated good levels of knowledge with a mean knowledge score of 10.1 out of 13 (95% CI: 9.95; 10.31). Pharmacists from the managerial level, ward pharmacy, in-patient, and medication therapy adherence clinic (MTAC) unit had better knowledge of antibiotics compared to pharmacists from other units (p < 0.001). Antibiotic knowledge gap had been identified among pharmacists in different work settings, and longer years of service does not warrant good antibiotic knowledge.

SummaryCatecholaminergic polymorphic ventricular tachycardia (CPVT) is a rare malignant arrhythmia, usually diagnosed in the adolescent years. The diagnosis can typically be made by one or more of the following: a positive family history, exercise electrocardiography, ambulatory ECG monitoring and/ or an intra-cardiac, electrophysiological examination. This is a case report of a patient with CPVT that was refractory to treatment with beta-blockade and an implanted automatic cardioverter defibrillator. However, after a selective serotonin re-uptake inhibitor (SSRI) was added to the therapeutic regimen, no further episodes of ventricular tachycardia occurred during the following two years.

No abstract