In a groundbreaking development, scientists at Northwestern University have developed the world's smallest pacemaker, a device so tiny it can be injected into the body through the tip of a syringe. Despite its minuscule size—just 1.8 millimetres wide, 3.5 millimetres long, and one millimetre thick—the new pacemaker delivers the same level of heart stimulation as traditional, full-sized models.

Can Work With Hearts Of All Sizes

Smaller than a grain of rice, the device is designed to work with hearts of all sizes, but its creators say it is especially suited for newborns with congenital heart defects. These fragile patients often require temporary pacing after surgery, a challenge that current bulky devices cannot address without invasive procedures.

"We have developed what is, to our knowledge, the world’s smallest pacemaker," said John A. Rogers, a bioelectronics expert at Northwestern University who led the development. “There's a crucial need for temporary pacemakers in pediatric heart surgeries. That’s a use case where size miniaturisation is incredibly important. In terms of device load on the body—the smaller, the better."

Bioresorbable And Non-Invasive

Currently, temporary pacemakers are implanted through surgery, where electrodes are sewn onto the heart muscle and connected to an external device via wires. These wires are later pulled out, which can sometimes damage the tissue. In contrast, this new wireless pacemaker is not only non-invasive but also bioresorbable—it dissolves safely into the body once its job is done.

The device does not rely on near-field communication or external wires. Instead, it is powered by a galvanic cell—a basic battery that uses chemical reactions to create an electrical current. Once the pacemaker comes into contact with the body's biofluids, it activates a chemical process that generates a current to stimulate the heart.

For monitoring and control, the pacemaker pairs with a soft, wearable patch placed on the patient's chest. This wearable system uses infrared light, which safely penetrates the body. “If the patient’s heart rate drops below a certain threshold, the wearable device detects the event and automatically activates a light-emitting diode (LED). The light then flashes on and off at a pace that mimics a normal heart rate,” the team explained.

The project was driven by the aim to support infants born with congenital heart defects, a condition affecting roughly one per cent of all newborns. “Our main focus was children,” said Northwestern cardiologist Igor Efimov. “Most of them only need temporary pacing after surgery. In about seven days, their hearts self-repair. This tiny pacemaker can support them during that critical period, without requiring another surgery for removal.”

The device and its innovative wireless technology were featured in a recent paper, "Millimetre-scale, bioresorbable optoelectronic systems for electrotherapy" in journal Nature. With this innovation, the future of cardiac care—especially for the most vulnerable patients—looks promisingly less invasive and far more gentle.

Dr. Mathew Samuel Kalarickal, a pioneer of interventional cardiology, has passed away on April 18, 2025, in Chennai, at the age of 77, marking an end to an era in coronary angioplasty and stenting technology. Popularly known as the 'Father of Angioplasty in India,' Dr. Kalarickal transformed heart care, changing the lives of thousands of patients and redefining the face of contemporary interventional cardiology.

Born on January 6, 1948, in Kerala, Dr. Kalarickal's journey to becoming one of the world's most renowned cardiologists was set early in life. After completing his medical studies at Kottayam Medical College, he went on to pursue specialization in cardiology from Chennai but his stint in the United States of America, under the guidance of Dr. Andreas Gruentzig—the man universally accepted as the 'Father of Coronary Angioplasty'—would establish the foundation for his groundbreaking career.

Dr. Kalarickal's return to India in 1985 proved to be turning point. Coronary angioplasty was a new, unexplored area in India at that time, and one that fell behind progress in the U.S. and Europe. Sensing this lacuna, Dr. Kalarickal chose to introduce this revolutionary procedure to India, with a vision of making lifesaving heart procedures reach more people.

First Angioplasty in India

In 1986, Dr. Kalarickal performed the very first angioplasty in India, a process which would subsequently alter the direction of heart treatment in the country. Angioplasty at that time was not a widely known procedure in India, and coronary artery disease was on the rise. During the first year, he had only treated 18 patients. But by 1987, that figure had risen to 150, an unmistakable indicator of both the increasing demand for this life-saving operation and the confidence that patients had in Dr. Kalarickal's skills.

His success in India did not remain confined to its borders, Dr. Kalarickal played a key role in setting up angioplasty centers in various nations in the Asia-Pacific region, such as Pakistan, Bangladesh, Sri Lanka, the United Arab Emirates, Indonesia, Thailand, and Malaysia. His relentless efforts to educate and train physicians in these nations helped ensure that this new technique spread like wildfire, eventually saving countless lives and making heart procedures more available worldwide.

Role of Dr. Kalarickal in Expanding Angioplasty Globally

Dr. Kalarickal's role was not just to bring angioplasty to India and the rest of the region. As an innovator, he was a pioneer in bringing new innovations to the world of angioplasty and stenting. One of his greatest feats was becoming the first Indian cardiologist to introduce and practice the application of drug-eluting bio-absorbable stents, which improved the efficacy of angioplasty by a large margin and minimized the threat of re-blockage in coronary arteries.

Having done more than 10,000 angioplasties, Dr. Kalarickal's expertise and commitment to improving heart health were second to none. He also contributed significantly to academia, establishing the National Angioplasty Registry of India, through which data on angioplasty operations could be gathered and analyzed to streamline and enhance practice nationwide. His contributions had an effect on the medical fraternity and made him a mentor to numerous budding cardiologists in India and overseas.

Dr. Kalarickal's success was not limited to the operating room. His leadership positions in major medical societies demonstrate his reputation as a world leader in interventional cardiology. He was president of the Asian-Pacific Society of Interventional Cardiology from 1995 to 1997 and then went on to chair the Asian-Pacific Society of Cardiology section of Interventional Cardiology between 1995 and 1999. His presidency in these societies promoted the use of angioplasty and stenting procedures around the world and consolidated the group of cardiologists in Asia.

His work was duly appreciated in many awards and honors. Dr. Kalarickal received the esteemed Padma Shri award in 2000, one of the highest civilian awards in India, for his outstanding work in cardiology. He was also awarded the Dr. B.C. Roy Award in 1996 for his notable contributions to medicine, the Doctor of Science Award by Dr. M.G.R. University in 2003, and a Lifetime Achievement Award in 2008.

While Dr. Kalarickal was well-known for his medical knowledge, he was as much admired for being a mentor. Dr. Sai Satish, who is a senior interventional cardiologist in Chennai, was trained by Dr. Kalarickal and collaborated with him for more than two decades. Talking about his experiences during his mentor's time, Dr. Satish stated, "There will never be another Dr. Mathew Samuel Kalarickal in my life.". He taught me in ways that few people ever managed, and I will miss him every time I enter a cath lab." This is a sentiment shared by many other cardiologists who were fortunate enough to learn from him. His dedication to educating and empowering the future generation of heart doctors has left an invaluable legacy on the specialty of cardiology.

Dr. Kalarickal's contributions have saved thousands of lives, and his legacy will never be lost in the profession of interventional cardiology. His vision, commitment, and pioneering attitude have revolutionized heart disease treatment in India and across the globe. With the advent of angioplasty, he revolutionized the procedure that used to be an extremely invasive and dangerous one and turned it into a routine, life-saving one.

How Angioplasty Saves Your Heart?

Angioplasty is a minimally invasive procedure to open up narrowed or blocked coronary arteries due to a buildup of fatty plaques. Plaque buildup in the arteries over time can limit blood supply to the heart, resulting in angina (chest pain) or even heart attacks. Angioplasty is done to relieve these blockages, restore normal blood flow, and prevent heart-related complications. But in what way precisely does angioplasty save the heart?

While undergoing angioplasty, a catheter is inserted into the clogged artery with a balloon at the end. The catheter is advanced through the bloodstream with great caution until it enters the area where the blockage is. Having reached its destination, the balloon is inflated, pushing the plaque against the artery walls, effectively opening up the artery and reinstating blood circulation to the heart. In most instances, a tiny mesh tube known as a stent is also inserted to keep the artery open and prevent it from closing again.

Angioplasty can be carried out in patients with different types of coronary artery disease, such as patients who have experienced heart attacks, those with chronic angina, and those at high risk for cardiac events due to plaque deposition. Angioplasty is commonly carried out on patients who are not ideal candidates for standard open-heart surgery.

Instant Relief and Long-term Advantages

Perhaps the greatest benefit of angioplasty is the relief that it brings promptly to the patient. Post-procedure, patients can notice dramatically decreased symptoms of chest pain, shortness of breath, and tiredness, all typical with clogged arteries. The normalization of blood flow tends to keep the heart from working as hard and lowers the risk of heart attacks.

In the long run, angioplasty ensures that the heart is not subjected to further harm by providing it with a sufficient supply of oxygenated blood. This is particularly vital in individuals suffering from coronary artery disease because continuous blood flow is crucial to maintaining heart muscle health. Angioplasty can greatly eliminate the risk of heart failure, heart attack, or stroke by opening up clogged arteries. Also, the procedure has been demonstrated to enhance quality of life in general, since patients are frequently able to resume normal activities following the procedure without the restrictions created by chest pain and other symptoms.

Breast cancer has long carried the weight of being an "older woman's disease" but that is changing fast with increasing numbers of young women being diagnosed with cancer. More women in their 20s and 30s being diagnosed, not decades later, but now. And in certain U.S. states, the figures are rising more quickly than anyone had predicted.

Where you live isn't just a lifestyle it could become a risk factor- from busy boroughs in New York to picturesque suburbs in Oregon, a recent study has revealed that young women in certain areas are being impacted at alarming levels. Whereas breast cancer has traditionally been linked with elderly age brackets, emerging trends are changing—and younger women in specific U.S. states are now being exposed to disproportionately greater risks.

So, are you in a state that requires more awareness, early testing, or lifestyle changes? This report digs deep into the statistics, knowing which states indicate the greatest risk of breast cancer in women under the age of 40—and what this will mean for your health now.

Because prevention begins with knowledge—and what you learn today could save your life or someone you love.

A new study indicates that where you reside in the United States may have a dramatic effect on your chances of getting breast cancer—particularly if you are under the age of 40. The results are part of a wide-ranging, multi-state study done by researchers at Columbia University's Mailman School of Public Health and published in the journal Cancer Causes & Control.

Researchers are increasingly sounding the alarm about a troubling trend: the growing incidence of early-onset breast cancer in women aged 25 to 39. This nationwide rise is now being shown to follow distinct geographic and racial patterns, prompting experts to call for more nuanced risk assessments and tailored public health strategies.

Young Women and Rising Breast Cancer Rates

The research examined U.S. Cancer Statistics data between 2001 and 2020 and revealed a 0.5% or higher yearly rise in breast cancer incidence among women younger than 40 in 21 states. Twelve of these states—California, New York, Massachusetts, and Illinois among them—had a statistically significant increase.

Geographically, the Western U.S. experienced the steepest rise in breast cancer rates among young women, and the Northeast saw the greatest absolute number of cases. Most strikingly, the South was the only region where rates remained flat—a trend researchers are still attempting to explain.

In the three-state region of New York, New Jersey, and Connecticut, young women continue to have very high rates of breast cancer. The top five highest rates of early-onset breast cancer include these states as well as Maryland and Hawaii. At the lowest, however, were states Idaho, Utah, North Dakota, Arizona, and Wyoming, and their rate of incidence was a 32% decrease from those with high risks.

Why Geography Matters in Breast Cancer Risk?

What is behind these regional disparities? The answer is probably complicated and multifaceted, according to Dr. Rebecca Kehm, the lead author of the study. "The rising incidence cannot be attributed to genetics," she said in a news release. "And it's not due to increased screening either—most women under age 40 aren't even in the age group where routine mammograms are recommended.

Rather, environmental exposures, urban residence, lifestyle trends, and state-level public health policy may all play a role. The study did not identify specific causes, though Kehm's research team is currently investigating links between early-onset breast cancer and outside factors such as endocrine-disrupting chemicals, alcohol consumption, and physical inactivity.

Is Alcohol Consumption A Factor in States at High Risk?

Drinking has been recognized as a reversible risk factor for breast cancer. Even casual drinking carries elevated risk: women who drink one per day are 7-10% more likely to develop the disease, while those who drink 2-3 per day have up to a 20% elevation.

Interestingly, a number of breast cancer high-risk states also have some of the highest per capita drinking rates. Based on the National Drug Helpline, New Hampshire, Delaware, and North Dakota are among the leading states in alcohol use, suggesting potential behavioral or cultural associations that deserve further investigation.

The research also indicated large racial and ethnic disparities. Non-Hispanic Black women most frequently presented with early-onset breast cancer, consistent with previous work demonstrating that they are at increased risk of developing aggressive types of the disease at younger ages. Hispanic women had the lowest rates of all regions.

Non-Hispanic White women were the only group to exhibit a steady rise in early-onset breast cancer in all four U.S. regions. These results highlight the need to take both race and location into account when assessing individual risk profiles.

What Is Early-Onset Breast Cancer?

Early-onset breast cancer is a diagnosis between ages 18 and 45. Although uncommon, it's frequently more aggressive and diagnosed later in life because there is less screening and awareness of the disease in younger women.

Common symptoms are:

• A breast or armpit lump
• Nipple discharge
• Inverted nipple
• Swelling or skin changes like dimpling or redness
• Bearing breasts which is persistent pain

Since routine mammogram screenings typically start at 40, a lot of young women don't realize they're at risk until symptoms become more difficult to disregard.

Breast Cancer Screening Guidelines

In reaction to the rise, the U.S. Preventive Services Task Force currently advises all women to start mammography screening every two years at age 40. This is a change from the earlier advice, which offered screening as an option beginning at age 40 but favored ages 50 to 74.

This shift is important. Based on the American Cancer Society, breast cancer in women younger than 50 is rising faster—around 1.4% a year—than their older peers.

Early-onset breast cancer isn't solely a matter of age or heredity—it's an incredibly contextual disease. State-level trends, environmental exposure, racial identity, and lifestyle decisions all intersect to determine a young woman's risk.

Public health professionals and primary care physicians need to think more locally and individually now in leading breast cancer prevention and education. "We hope this research leads to more personalized screening recommendations and environmental studies," Kehm said.

While the science develops, one thing is clear—knowing your geography may be as crucial as knowing your family history when it comes to breast cancer risk.

In a breakthrough step towards safeguarding infant and toddler health, the Government of India has formally prohibited the use of some commonly found over-the-counter (OTC) cough and cold medicines in children below the age of four. This policy move, as notified by the Union Ministry of Health and Family Welfare through a gazette notification, prohibits the use of a fixed-dose combination (FDC) of Chlorpheniramine Maleate and Phenylephrine Hydrochloride—two ingredients found in many pediatric cough syrups.

The decision follows an increasingly vocal global health chorus of alarm at the safety of these products among very young children, India now being among the latest to make strong regulatory moves.

The fixed-dose combination in question has been used to alleviate symptoms of the common cold and allergic rhinitis for a long time. Nonetheless, after reviewing the same, a Subject Expert Committee (SEC) constituted by the Central Government with suggestions from the Drugs Technical Advisory Board (DTAB) opined that this combination is likely to produce risks for children under four years of age—risks overweighing possible benefits.

As per the Health Ministry's statement, "the use of the fixed-dose combination is likely to pose risk to children under the age of four, and safer options to the aforementioned drug are in place."

The government used Section 26A of the Drugs and Cosmetics Act, 1940, to limit the production, sale, and supply of these formulations for pediatric administration in India.

What Are These Drugs?

The now-restricted combination consists of two commonly prescribed ingredients:

Chlorpheniramine Maleate: An antihistamine that operates by inhibiting histamine receptors in the body, relieving symptoms such as sneezing, watery eyes, and runny nose.

Phenylephrine Hydrochloride: A decongestant that constricts blood vessels in the nostrils to narrow them and improve breathing.

Collectively, they've had different brand names and are household essentials in all Indian homes for treating cold as well as allergy conditions. The preparations, though usually safe for adults and older kids, are found to be potentially unsafe for toddlers.

Why the Risk is Greater for Toddler?

Infants under the age of four are at greater risk for side effects due to their immature organ systems and lower body weight. Even normal doses can produce exaggerated physiological effects.

Drowsiness, restlessness, dizziness, or even paradoxical excitation (hyperactivity rather than sedation) can result from chlorpheniramine and be particularly hazardous in infants.

Phenylephrine is a stimulant that can raise blood pressure, induce palpitations, and produce headaches. Its vasoconstricting effect, while useful in nasal decongestion, can impose excessive strain on a child's cardiovascular system.

All these compounds, when used in combination, have an intricate pharmacological profile that can do unintended damage if taken without tight medical surveillance.

Apart from prohibiting the mixture for children under four, the government has asked manufacturers to put a clear warning label on all packaging, inserts, and advertising materials.

The warning that must be used is: This fixed-dose combination shall not be used in children below four years of age.

This choice isn't just a one based on regulation but rather an educational choice as well, trying to notify parents, caregivers, and healthcare workers of the danger of self-medicating infants and toddlers outside of a physician's recommendation.

Are There Safer Alternatives?

Yes, the prohibition is the result of the availability of safer, more targeted alternatives. Pediatricians frequently suggest utilizing saline nasal drops, humidifiers, or warm liquids to relieve cold symptoms in children. In more severe instances, medications targeting specific symptoms are prescribed under close dosage control.

It's crucial to keep in mind that a majority of colds are viral infections that naturally go away by themselves. Medicating symptoms with aggressive medication, particularly in kids under four years old, more often than not causes more damage than good.

What Should Parents Do Now?

• Talk to pediatricians before administering any OTC cold or allergy medication to kids.
• Don't use leftover or adult-strength formulas, even in reduced amounts.
• Read labels before buying drugs and look for the new government-required warning.
• Watch for side effects if the drug has already been taken and obtain instant medical care for any side effects.

India's regulatory action reflects worldwide thinking. Other nations such as the U.S., Canada, and the U.K. had earlier issued guidelines or warnings concerning the use of OTC cough and cold medicines among young children.

In the United States, the FDA recommends against administration of cold drugs to children less than two and cautions against even those two to six. Likewise, the American Academy of Pediatrics (AAP) has cautioned against the use of OTC cough and cold medicines in kids less than four years old as a matter of long-standing concern regarding insufficient benefit and possible risks.

India's move is consistent with this evidence-based strategy, reinforcing the global push toward child-specific formulations, careful monitoring, and public health education.

The prohibition on children under four using cough syrup combinations is an important step towards more rational and safer use of drugs in pediatric care. As greater awareness emerges regarding the subtleties of treating younger children, particularly in non-clinical environments, policy like this one serves to protect the most vulnerable groups.

For parents, the message is simple: drugs that are effective for adults or older kids are not necessarily safe for toddlers. If it's questionable, always call a physician.