ObjectiveFew studies have looked at the predictors of use of home sphygmomanometers among hypertensive patients in low-income countries such as Pakistan. Considering the importance of home blood pressure monitoring (HBPM), cross-sectional study was conducted to evaluate the prevalence and predictors of the usage of all kinds of HBPM devices.MethodThis study was conducted in Karachi during the time period of January-February 2017. Adult patients previously diagnosed with hypertension visiting tertiary care hospitals were selected for the study. Interviews from the individuals were conducted after verbal consent using a pre-coded questionnaire. The data was analyzed using Statistical Package for the Social Sciences v. 23.0 (SPSS, IBM Corporation, NY, USA). Chi-squared test was applied as the primary statistical test.ResultsMore than half of the participants used a home sphygmomanometer (n=250, 61.7%). The age, level of education, family history of hypertension, compliance to drugs and blood pressure (BP) monitoring, few times a month at clinics were significant determinants of HBPM (P values < 0.001). It was found that more individuals owned a digital sphygmomanometer (n=128, 51.3%) as compared to a manual type (n=122, 48.8%). Moreover, avoiding BP measurement in a noisy environment was the most common precaution taken (n=117, 46.8%).ConclusionThe study showed that around 40% of the hypertensive individuals did not own a sphygmomanometer and less than 25% performed HBPM regularly. General awareness by healthcare professionals can be a possible factor which can increase HBPM.

This study investigates and compares fatigue behavior of forged steel and powder metal connecting rods. The experiments included strain-controlled specimen testing, with specimens obtained from the connecting rods, as well as load-controlled connecting rod bench testing. Monotonic and cyclic deformation behaviors, as well as strain-controlled fatigue properties of the two materials are evaluated and compared. Experimental S-N curves of the two connecting rods from the bench tests obtained under R =-1.25 constant amplitude loading conditions are also evaluated and compared. Fatigue properties obtained from specimen testing are then used in life predictions of the connecting rods, using the S-N approach. The predicted lives are compared with bench test results and include the effects of stress concentration, surface finish, and mean stress. The stress concentration factors were obtained from FEA, and the modified Goodman equation was used to account for the mean stress effect. Fractography of the connecting fracture surfaces were also conducted to investigate the failure mechanisms. A discussion of manufacturing cost comparison and recent developments in "crackable" forged steel connecting rods are also included.