Background The Himachal Pradesh state acute coronary syndrome registry recorded a median delay of 13 h between the time of onset of pain to the time of making the diagnosis and giving treatment for acute coronary syndrome. We conducted a pilot study on providing 24-h tele-electrocardiography (Tele-ECG) services in the district Kangra of Himachal Pradesh, with the aim to reduce the time taken for diagnosis of acute coronary syndrome. Methods The intervention group for the study included eight rural community health centres, each with one to three primary care physicians, who were all unskilled in electrocardiogram interpretation. We provided them with 24-h Tele-ECG support. The primary care physicians used their smartphones to transmit the electrocardiogram image to the command centre, which was then read by the skilled specialist physicians in our medical college hospital and the report sent back within five minutes of having received the electrocardiogram. Antiplatelets were given by the primary care physician to patients diagnosed with acute coronary syndrome, who was then transported to the medical college hospital. The urban sub-divisional hospitals ( n = 6) formed the control group for the study. These hospitals had five to fifteen unskilled primary care physicians and one to two skilled specialist physicians; no intervention was done in this group. A pilot was run from February 2015-January 2016. Results We received 819 Tele-ECG consultations within the intervention group; 157 cases of acute coronary syndrome were confirmed and transferred to our medical college hospital facility. Similarly, we admitted 177 cases of acute coronary syndrome at the medical college hospital, who were first attended to by the primary care physician in the control group. Aspirin was administered to 91% and 58% of patients with acute coronary syndrome in the intervention and the control groups, respectively ( p < 0.0001). The median hospital-to-aspirin time (h) in the intervention and the control groups was 0.7 ± 1.45 h and 3.5 ± 10 h, respectively ( p < 0.0001). In the intervention group, 72% of the ST elevation myocardial infarction patients were diagnosed within 12 h by the primary care physician using Tele-ECG support. Interpretation and conclusions Smartphone-based Tele-ECG support for primary care physicians reduced the hospital-to-aspirin time in acute coronary syndrome significantly ( p < 0.0001). This is an effective low cost strategy and is easily replicable anywhere in the world.

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Throughput and performance are the major constraints in designing system level models. As vector processor used deeply pipelined functional unit, the operation on elements of vector was performed concurrently. It means the elements were processed one by one. Improvement can be made in vector processing by incorporating parallelism in execution of these concurrent operations so that these operations can be performed simultaneously. This paper presents a design and implementation of SIMD-Vector processor that implements this parallelism on short vectors having 4 words. The operation on these words is performed simultaneously i.e. the operation on these words is performed in one cycle. This reduces the clock cycles per instruction (CPI). To implement parallelism in vector processing requires parallel issue and execution of vector instructions. Vector processor operates on a vector and superscalar processor issues multiple instructions at a time. This means parallel pipelines are implemented and then made these to support vector data. SIMD-Vector processor will operate on short vector say 4 words vector in a superscalar fashion i.e. 4 words will be fetched at a time and then executed in parallel. This requires redundant functional units e.g. if addition is to be performed on two vectors multiple adders are needed. We have designed the architecture of SIMD type Vector processor. All the designing parameters are explained. KeywordsSIMD type Vector processor, vertical and horizontal parallelism, ILP.

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