
anusaranm (marunnu)

vaidyashaasthrathil, oru rogi ethratholam vaidyopadesham shariyaayi pinthudarunnuvennu rogi paalikkal (anusaranavum capaasittansum) vivarikkunnu. saadhaaranayaayi, ithu marunnukaleyo mayakkumarunnu palikkalukaleyo soochippikkunnu, ennaal medical upakaranangalude upayogam, svayam paricharanam, svayam niyantritha vyaayamangal allengil therapy sessionukal thudangiya mattu saahacharyangalilum ithu baadakamaakum. rogiyum aarogya parirakshaa dathavum anusaranathe badhikkunnu, koodaathe oru nalla doctor rogiyum thammilulla bandhamaan paalikkal mechappeduthunnathinulla ettavum pradhanappetta ghadakam. paricharanatthinulla praveshanam rogi anusarikkunnathil oru punk vahikkunnu, athuvazhi paricharanam labhikkunnathin kooduthal kaathiripp samayangal kooduthal haajaraakunnathin kaaranamaakunnu. kurippadi marunninte vilayum oru pradhana punk vahikkunnu.
oru rogiyum clinisian orumichu chikilsayekkurichu theerumaanangal edukkunna prakriyaya konkordansumaayi paalikkal aashayakkuzhappathilaakkam.
lokamembaadum, aarogya parirakshayude phalapradamaaya vitharanathinu paalikkaathirikkuka ennathu oru pradhana thadassamaanu. 2003-leeii lokaarogya samghadanayude kanakkukal soochippikkunnathu vikasita rajyangalil thamasikkunna vittumaaraatha rogangalulla rogikalil 50 sathamaanam perr maathramaan aasthma, prameham, rakthaathimarddam ennivaykkulla chikilsakal palikkunna kuranja nirakkilulla chikitsa shupaarshakal pinthudarunnathu. aadhunika marunnukalude sankeernnatha, mosham "aarogya saksharatha", chikitsa aanukoolyangal manasilaakkaathathu, charcha cheyyappedaattha paarshwafalangal, mosham chikitsa samthrupthi, kurippadi marunninte chelavu, mosham ashayavinimayam allengil vishwaasakkuravu enniva palikkunnathinulla pradhana thadassangalil ulppedunnuvennu karuthappedunnu. marunnukalude packaging lalithamaakkuka, phalapradamaaya marunnukalude oormmappeduthalukal nalkuka, rogiyude vidyaabhyaasam mechappeduthuka, oresamayam nirddeshikkunna marunnukalude ennam parimithappedutthuka ennivayaanu paalikkal mechappeduthunnathinulla sramangal lakshyamidunnathu. marunnukalude anusaranm mechappeduthunnathinulla edapedalukalude savisheshathakaludeyum phalangaludeyum kaaryatthil padanangal valia vyathiyaanam kaanikkunnu. vaidyashaasthraparamaayi pradhanappetta phalangal prothsaahippikkunnathi anusaranm engane sthiramaayi mechappeduthaamennu ippozhum vyakthamalla.
padavali.
vaidyashaasthrathil, oru rogi ethratholam vaidyopadesham shariyaayi pinthudarunnuvennu paalikkal (anusaranathinte paryayam, kappaasittans) vivarikkunnu. saadhaaranayaayi, ithu marunnukaleyo mayakkumarunnu palikkalukaleyo soochippikkunnu, ennaal ithu medical upakaranangalude upayogam, svayam paricharanam, svayam niyantritha vyaayamangal allengil therapy sessionukal ennivaykkum baadhakamaan. rogiyum aarogya parirakshaa dathavum anusaranathe badhikkunnu, koodaathe oru nalla doctor rogiyum thammilulla bandhamaan paalikkal mechappeduthunnathinulla ettavum pradhanappetta ghadakam.
2003 leeii kanakkanusarichu, us aarogya parirakshaa professionalukal saadhaaranayaayi "paalikkal" ennathinekkaal oru rejimen "paalikkal" enna padam upayogichu, kaaranam rogikal chikitsa nirddeshangal bhaagikamaayo poornnamaayo paalikkaatthathinte vaividhyamaarnna kaaranangale ithu nannayi prathifalippikkumennu karuthappedunnu. koodaathe, sariyaaya marunnu, doses, root, samayam, aavruthi ennivayumaayi bandhappett doctor nirddeshicha marunnukal kazhikkaanulla rogiyude kazhivu anusarikkal enna padatthil ulppedunnu. paalikkal ennathu utharavukal nishkriyamaayi pinthudarunnathine maathrame soochippikkukayulloo ennu sradhikkappettittundu. anusarana" enna padam palappozhum oru rogiyum clinisian thammilulla theerumaanamedukkalinum chikilsaykkumulla sahakarana sameepanathe soochippikkaan upayogikkunnu.
2003 leeii oru enhs samrambhathe soochippikkunna, anusarana mechappeduthunnathinaayi chikitsa prakriyayil oru rogiye ulppeduthaan yunaittad kingdatthil concordence enna padam upayogichittundu. eee pashchaathalatthil, rogiye avarude avasthayekkurichum chikitsa oopshanukalekkurichum ariyikkukayum eathu nadapadi sweekarikkanamenna theerumaanatthil earppedukayum teamine nireekshikkunnathinum report cheiyunnathinum bhaagikamaayi utharavaadithamullavaraayi maarukayum cheiyunnu. rogiyude apakadasaadhyathakalum nettangalum manassilakkiya sesham chikitsa vendennu theerumaanikkumbozhaanu bodhapoorvamaaya manahpoorvamaaya anusaranamillaayma.
2005 vare, mungananayulla padavali charchaavishayamaayi thudarnnu. 2007 leeii kanakkanusarichu, doctor rogiyumaayi sahakarichu sajjeekarikkunna oru chikitsa reethi rogi paalikkunnathine prathyekamaayi soochippikkaan concordence upayogikkunnu, ithu doctor maathram nirddeshikkunna chikitsa reethi paalikkunnathil ninnu verthirikkunnu. thudarchayaaya charchakalkkidayilum, lokaarogya samghadana, american faarmasist association, yuu. ezz. ennivaykku anusaranamaanu munganana.ezz. naashanal instittyoott oof health fleedens research network. yunaittad stetts naashanal library oof medisinte medical vishaya thalakkettukal palikkal palikkal enna vaakkukalode vividha padangale nirvachikkunnu. rogi palikkal marunnu palikkal chikilsayude anusaranathinteyum palikkalinteyum mesh treak keezhil verthirichirikkunnu.
anusarana gadakangal.
chikitsa reethikal nirddeshichittullavillar pakuthiyolam perum nirddeshichathupole avaa palikkunnilla.
paarshwafalangal.
oru marunninte prathikoola paarshwafalangal paalikkunnathine swaadheenikkum.
aarogyaparamaya saksharatha.
aarogya saksharatha' ennu vilikkappedunna chikilsayude nirddeshangalekkurichulla mosham dharana chelavum chikitsa palikkunnathinulla pradhana thadassangalaayi ariyappedunnu. vidyaabhyaasavum shaareerika aarogyavum parasparabandhithamaanennathinni sakthamaaya thelivukalundu. vidyaabhyaasathile mosham nettangal aarogya asamathvangalude chakratthile oru pradhana gadakamaanu.
thozhil vipaniyile oru vyakthiyude sthaanam, avarude varumaana nilavaaram, athinaal vibhavangalilekkulla avarude praveshanam enniva nirnnayikkaan vidyaabhyaasa yogyathakal sahayikkunnu.
saksharatha.
1999ll yukeyile muthirnnavaril anjilonnu perkkum, athaayath ekadesham ezhu dasalaksham aalukalkk, adisthaana kazhivukal, prathyekichu pravarthanaparamaaya saksharatha, pravarthanaparamaaya samkhyaashaasthram ennivayil prasnangal undaayirunnu, "engleeshil vaayikkanum ezhuthaanum samsaarikkanumulla kazhivu, jolisthalathum pothuve samoohathilum pravartthikkaan aavashyamaaya thalatthil ganithashaasthram upayogikkuka" enningane vivarikkappedunnu."ithu phalapradamaayi marunnu kazhikkaanum labelukal vaayikkanum mayakkumarunnu reethikal pinthudaraanum kooduthal kandethaanum avarkk asaadhyamaakki.
2003ll, yukeyile muthirnnavaril 20 sathamaanam perkku deerghakaalamaayi asukhamo vaikalyamo undaayirunnu, yuke aarogya vakuppinte deseeya padanatthil, mosham allengil valare mosham aarogyamullavaril moonnilonnu perkkum entry level 3 allengil athil thaazheyulla saahitya vaidagdhyamundennu kandethi.
kuranja thothilulla saaksharathayum samkhyaashaasthravum saamoohika-saambathika nashtavumaayi bandhappettirikkunnave kandethi. englandinte vadakkukizhakkan bhagangal polulla kooduthal pinnakkam nilkkunna pradeshangalile muthirnnavar thekkukizhakkan bhagangal polulla pinnakkam nilkkunna pradeshangale apekshichu thaazhnna nilayilaanu prakadanam nadathiyathu. praadeshika adhikaarikalude kudiyanmarum mosham aarogyamullavarum adisthaana vaidagdhyangal illaathavaraakaan saadhyathayund.
2002ll nooriladhikam yuke praadeshika vidyaabhyaasa authority mekhalakalile oru vishakalanathil, aii. dii. 1 vayassil vidyaabhyaasa nettam coronary hrudrogavumaayum thudarnnulla sisumaranavumaayi shakthamayi bandhappettirikkunnave kandethi.
saaksharathayum aasthma vijnjaanavum thammilulla bandhathekkurichulla oru patanam velippeduthi, haiskool birudadhaarikalaaya vaayana nilavaaramulla 90 shathamaanavumaayi thaarathamyappeduthumbol, 10 vayassulla vaayana nilavaaramulla aasthma rogikalil 31 sathamaanam perkkum aasthma akramanam illengilum doctormaare kaanendathundennu ariyamaayirunnu.
chikilsayude chelavu.
2013ll yuu. ezz. naashanal community faarmasist association 40 vayassinu mukalilulla 1,020 amerikkakkaare oru maasathekku sample cheyyukayum vittumaaraatha avasthaykku marunnu kazhikkaan thudarchayaaya kurippadi nalkukayum cheythu. 2009ll ithu prathivarsham 290 bilyan dollar chelavu varuthiyathayi kanakkaakkappedunnu. 2012ll, rogiyude marunnukalude chelavu vihithathile vardhanavu marunnukalude kuranja anusaranavumayi bandhappettirikkunnave kandethi.
marunnukalude ettavum uyarnna vilayulla raajyangalilonnaan america, pradhaanamaayum farmaceutical vyavasaayathile kuthakakalumaayi kuranja vila charcha cheyyaathathinu, prathyekichu brand naamamulla marunnukalumayi. marunnukalude chelavu niyanthrikkunnathin, deerghakaala chikilsayilulla pala us rogikalum avarude kurippadi poorippikkunnathilo ozhivaakkunnathilo dosukal kuraykkunnathilo paraajayappedunnu. 2015leeii kaisar famili foundeshan sarway prakaram, naalil moonnu bhaagavum (73 sathamaanam) pothujanangal marunninte vila yukthirahithamaanennu karuthukayum vila ithrayum uyarthiyathinu farmaceutical kambanikale kuttappeduthukayum cheiyunnu. athe reportil, pothujanangalil pakuthiyum thangal kurippadi marunnukal kazhikkunnundennum "nilavil kurippadi marunnu kazhikkunnavaril naalilonn (25 sathamaanam) perum kazhinja 12 maasathinide chelavukal kaaranam kurippadi poorippichittillennum 18 sathamaanam perum gulikakal pakuthiyaayi vettikkuraykkunnatho dosukal ozhivaakkunnatho aanennum" report cheythu. 2009ll kaanadayumaayi thaarathamyappeduthumbol, 8 sathamaanam muthirnnavar maathramaan avarude dosukal ozhivaakkukayo avarude nirddishta marunnukalude vila kaaranam avarude kurippadi poorippikkaathirikkuyo cheythathayi report cheythath.
praayam.
cheruppavum praayamaayathumaaya padavi anusarikkaathathumaayi bandhappettirikkunnu.
praayamaayavarkk palappozhum onniladhikam aarogyaprasnangalundu, yuke janasamkhyayude 20 sathamaanam maathram prathinidheekarikkunnumdum ellah enhs marunnukalilum pakuthiyolam viramikkal praayathilulla aalukalkkaayi nirddeshikkappedunnu. praayamaayavarude paricharanathekkurichulla sameepakaala deseeya sevana chattakkood eee janasamkhyayil marunnukal kazhikkunnathinum phalapradamaayi kaikaaryam cheiyunnathinumulla praadhaanyam eduthukaanichu. ennirunnaalum, prayamaaya vyakthikalkk idaykkide dossing ulla onniladhikam marunnukal ulppedeyulla velluvilikal neridendivannekkaam, koodaathe vaidagdhyam allengil vaijnjaanika pravartthanam kurayaan saadhyathayund. rogiyude arivu nireekshikkappettitla oru aashankayaan.
1999ll kline thudangiyavar. ashupathriyil ninnu discharge cheyyappetta prayamaaya rogikalil marunnukalekkurichulla arivile niravadhi vidavukal kandethi. rekhaamoolavum vaakkaalullathumaaya vivarangal labhichittum, hridayasthambhanathe thudarnnu discharge cheyyappetta praayamaayavaril 27 sathamaanavum 30 divasathinullil anusarikkaathavaraayi tharamthirichu. sarveyil pankeduttha rogikalil pakuthiyolam perkkum thangal nirddeshicha marunninte alavu oorkkaan kazhinjilla, moonnil rund perkkum divasathil eathu samayathaan kazhikkendathennu ariyillaayirunnu. 2001ll baarattum mattullavarum nadatthiya oru patanam. veettil thamasikkunna 75 vayassulla janasamkhyayile medical arivum anusarikkunnathinte gadakangalum vilayiruthi. prayamaaya rogikalil 40 sathamaanam perkkum avarude bhakshanakramatthinte uddeshyam ariyillennum 20 sathamaanam perkku maathrame athu paalikkaatthathinte anantharafalangal ariyaamaayirunnulloovennum avar kandethi. dhaarana, polypharmacy, jeevita krameekaranam, onniladhikam doctormar, paalikkal sahaayangalude upayogam enniva anusaranavumayi bandhappettirikkunnu.
aasthma svayam-maanejment palikkunna kuttikalil nirnaayakamaan, koodaathe saha-rogaavasthakal phalangale baadikkunnathaayi rekhappeduthiyittundu; 2013 ll electronic nireekshanam palikkaan sahaayikkumenn nirddeshikkappettittund.
vaikalyangalulla kuttikalilum kaumaarakkaarilum chikitsa paalikkunnathinte saamoohika gadakangal padikkappettittund
vamseeyatha.
vividha vamseeya pashchaathalangalilppetta aalukalkk saksharatha, shareerashaasthram, samskaaram allengil daaridryam ennivayiloode savisheshamaaya anusarana prashnangalund. vamseeya nyoonapaksha samudaayangalil vaidyashaasthram pinthudarunnathinekkuri prasidheekaricha padanangal kuravaanu. screening paripaadikalil pankedukkunnathum thudarnadapadikalkkulla hajar nilayum polulla aarogya nirnaya swabhaavathe vamsheeyathayum samskaaravum swaadheenikkunnu.
priyetto" thudangiyavar anusaranathil vamsheeyavum saamskaarikavumaaya gadakangalude swaadheenathinu oonnal nalki. aarogyatheyum rogatheyum kurichulla avarude manobhaavangalilum moolyangalilum vishwaasangalilum grouppukal vyathyasthamaanennu avar choondikkaatti. eee kaazhchappaad anusaranathe badhikkum, prathyekichu prathirodha chikilsakalilum rogalakshanangalillaatha avasthakalkkulla marunnukalilum. koodaathe, chila samskaarangal thangalude nallatho mosham aarogyamo avarude daivangalkku (kall) maarakamaayi aaropikkukayum mattullavare apekshichu svayam paricharanatthinu kuranja praadhaanyam nalkukayum cheiyunnu. athum
vividha vamseeya allengil saamskaarika grouppukalkkaayi anusarikkunna nadapadikal parishkkarikkendathundu. chila sandarbhangalil, rogikale avarude vyakthigatha chikilsayekkurichu theerumaanangal edukkunnathinu munbu saamskaarika veekshanakonil ninnu vilayiruthunnathu uchithamayirikkum.
karuthavarggakkaaraaya rogikaleyum svakaaryamallaatha insurance ullavareyum anusaranamillaathavaraayi mudrakuthaan saadhyatha kooduthalaanennu sameepakaala padanangal theliyichittundu. niyantritha eiii1sii ulla rogikalilum mattu saamoohika saambathika gadakangale niyanthrichathinusheshavum polum vardhicha apakadasaadhyatha nireekshikkappedunnu.
kurippadi poorippikkal nirakkukal.
ellah rogikalum oru faarmasiyile kurippadi poorippikkilla. 2010ll yuu.ezz. padanamanusarichu, kurippadikalude 20-30% orikkalum faarmasiyil nirachirunnilla. aalukal kurippadi poorippikkaatthathinte kaaranagal marunninte vila ulppedunnu, 2001 ll 1,010 muthirnnavaril nadatthiya us rajyavyaapaka sarveyil 22 sathamaanam perr kurippadi poorippikkendathillenna kandethi, kaaranam vila 20-30% motham nirakkin samaanamaan. mattu gadakangal marunninte aavasyakathaye samshayikkukayo allengil marunnukal ozhikeyulla svayam paricharana nadapadikalkku munganana nalkukayo cheiyunnu. soukaryam, paarshwafalangal, prakadamaaya nettatthinte abhavam ennivayum gadakangalaanu.
marunnu kaivasham vaykkunnathinulla anupatham.
poorippikkal nirakkinte adisthaanathil marunnu paalikkunnath kanakkakkaan kurippadi medical claim rekhakal upayogikkaam. divasangalude marunnu vitharanathe rogi marunnu kazhikkenda divasangalude ennathaal harikkukayaanenkil kuranjathu 80 shathamaanamenkilum nalkunna marunninte alavu aanenkil rogikale 'anusaranamulla rogikal' ennu pathivayi nirvachikkaam. eee shathamaanathe medisin opeseshan anupatham (emm. pii. aarr) ennu vilikkunnu. 2013leeii padanangal soochippikkunnathu 90 shathamaanamo athil kooduthalo ulla marunnu kaivasham vaykkunnathu upabhogathe 'anusaranamulla' aayi kanakkaakkunnathin mikacha paridhi aayirikkam.
sthiravum variable enningane rund tharatthilulla emm. pii. aarr. kanakkukoottaam. randennam kanakkaakkunnath thaarathamyena neraayathaan, variable mpr (vmpr)-nuu ithu kanakkaakkunnath divasangalude vitharanathe avasana kurippadi ulppede kazhinja divasangalude ennathaal harikkunnu.
soothravaakyam _ 1
nischitha emm. pii. aarr. (eph. emm. pii. aarr)-nuu kanakkukoottal samaanamaan, ennaal denominator ennathu oru varshathe divasangalude ennamaanu, athesamayam numerator rogi nirddeshicha varshathinullile divasangalude vitharanamaayi parimithappedutthiyirikku.
soothravaakyam _ 2
gulika roopathilulla marunnukalkk oru kurippadi adisthaanamaakki divasangalude vitharanam kanakkaakkunnath thaarathamyena neraanu. chila marunnukal neraayavayalla, kaaranam oru nischitha ennam dosukal nalkunna kurippadikku divasangalude vitharanathil vyathyaasamundaakam, kaaranam prathidinam edukkenda dosukal vyathyaasappedunnu, udaaharanathinu aasthmaykk nirddeshichittulla preventive corticosteroid inhalerukalil, divasena edukkenda shwasanangalude ennam rogathinte theevrathaye adisthaanamaakki vyakthikalkkidayil vyathyaasappedaam.
sandarbhochitha gadakangal.
maanasikaavasthakal polulla vyakthiparamaaya saahacharyangalkoppam sandarbhochitha gadakangalum theerumaanangale badhikkunnu. mikka sandarbhochitha vivarangalum thirichariyunna theerumaanangal krithyamaayi pravachikkaan avarkk kazhiyum. ottappedal pinthudarunnathinulla shupaarshakal pothuvaayi paalikkunnath anubaadhayil ninnu samrakshikkaan aarogya munkaruthalukal edukkuka, durbalata anubhavappeduka, covid-19 neduka, sarkkaaril vishwaasam enniva polulla vishwaasangale swaadheenikkunnu. nayanirmmaathaakkalil vishwaasathinte thoth kooduthalulla europian pradeshangalile mobility kuraykkuka, kwaarantain niyanthranangal palikkuka enniva oraal isolation niyamangal paalikkunnundo ennu swaadheenikkum. koodaathe, covid-19 nte pakarchavyaadhi niyamangalude paalikkalinte sakthamaaya pravachanamaan, athaayath kooduthal pakarchavyaadhi aalukal covid-19 aanennu karuthunnu, saamoohika akalam paalikkanulla nadapadikal edukkunnu, athesamayam kadamayekkurichulla bodhavum vairasinekkurichulla bhayavum veettil thanne thudaraan kaaranamaakunnu. niyanthranangal phalapradamaanennu vishwasikkunnatho mattullavare vishwasikkunna vyakthikal illaathavarekkaal kooduthal paalikkal prakadippikkunnatho aaya uyarnna adhikaarathil vaykkunnathu kaaranam aalukal avarude veedukal vidaanidayilla. paalikkaatha aalukal avaye prasnakaramaayi kaanumbol, palikkunna vyakthikal samrakshana nadapadikal phalapradamaayi kaanunnu.
kozhs poortthiyaakkuka.
orikkal aarambhichukazhinjaal, rogikal nirddeshichathupole chikitsa reethikal apoorvvamaayi maathrame pinthudarunnulloo, apoorvvamaayi maathrame chikilsayude kozhs poortthiyaakkaarulloo. rakthaathimardhathinte kaaryatthil, 50 sathamaanam rogikalum roganirnayam nadatthi oru varshathinullil paricharanam poornnamaayum upekshikkunnu. chikilsayude aadya varshathil aadya nirayile eaka antihypertensive marunnukalude sthiratha valare kuravaanu. lipid kuraykkunna chikitsa sambandhichidatholam, rogikalil moonnilonnu perr maathramaan avarude chikilsayude 90 shathamaanamenkilum paalikkunnath. rogiyude paricharana edapedalukalude theevratha (udha.jii. electronic oormmappeduthalukal, faarmasist nayikkunna edapedalukal, rogikalude aarogyaparipalana professional vidyaabhyaasam) lipid kuraykkunna marunnukal, motham collustroll, ldl-collustroll ennivayude alavu ennivayil rogi palikkunna nirakk mechappeduthunnu.
lokaarogya samghadana (doubleuecho) 2003-ll kanakkaakkiyath, 50 sathamaanam aalukal maathramaan vittumaaraatha rogangalkk deerghakaala chikitsa poortthiyaakkunnathu, ithu rogiyude aarogyathe apakadatthilaakkunnu. udaaharanathinu, 2002-ll rund varshathe chikilsaykku sesham stattin paalikkal 25 muthal 40 sathamaanam vare kuranju, rogikal prathirodha kaaranangalal stattinukal edukkunnathu asaadhaaranamaamvidham mosham kamplayarmaaraanennu avar karuthunnu.
nirddishta chikilsakal poortthiyaakkaan rogikale sahaayikkunnathin vaividhyamaarnna packaging sameepanagal nirddeshichittundu. eee sameepanagalil dosage rejimen oormmikkaanulla eluppam vardhippikkunna formaattukalum dishakalekkurichulla rogiyude dhaarana vardhippikkunnathinulla vyathyastha labelukalum ulppedunnu. udaaharanathinu, marunnukal chilappol marunnu kazhikkunnathinulla divasathinum/allengil aazhchayile samayathinum oormmappeduthal samvidaanangalaal niranjirikkunnu. rakthasammardham polulla klinikkal phalangal mechappeduthaan oormmappeduthal packaging sahaayikkumenn chila thelivukal kaanikkunnu.
europian rogikalude samghadanakalude prathinidhikalumayi farmaceutical vyavasayamaaya packaging vyavasaayathin idayil health cair compliance packaging kaunsil oof europe (echsipisi-europe) enna laabhechayillaathe pravartthikkunna oru samghadana roopeekarichu. packaging parihaarangalude upayogathiloode rogiyude paalikkal mechappeduthunnathil aarogya samrakshana mekhalaye sahayikkukayum bodhavalkarikkukayum cheyyuka ennathaanu echu. sii. pii. sii-yooroppinte dauthyam. eee sahakaranathiloode vividha packaging pariharangal vikasippichittund.
lokaarogya samghadana anusarikkunnathin thadassangal srishtikkunnu.
lokaarogya samghadana (aarr) marunnukal palikkunnathinulla thadassangale anchu vibhagangalaayi tharamthirikkunnu; aarogya parirakshaa samghavum samvidaanavumaayi bandhapetta gadakangalum, saamoohikavum saambathikavumaaya gadakangal, avasthayumaayi bandhapetta gadakangal, chikilsayumaayi bandhapetta gadakangal, rogiyumaayi bandhapetta gadakangal. pothuvaaya thadassangalil iva ulppedunnu
paalikkal nirakk mechappeduthuka.
aarogya parirakshaa daathaakkalude punk.
aarogya parirakshaa daathaakkal paalikkal prasnangal mechappeduthunnathil valia punk vahikkunnu. providermark prachodanaathmakamaaya abhimukhathiloodeyum sajeevamaaya shravanathiloodeyum rogiyude edapedalukal mechappeduthaan kazhiyum. rogiyude aavasyangalkku ardhavathaaya oru padhathi thayyarakkan aarogya parirakshaa daathaakkal rogikalumaayi pravartthikkanam. vishwaasam, sahakaranm, paraspara utharavaaditham enniva vaagdaanam cheiyunna oru bandhathinu dathavum rogiyum thammilulla bandham valareyadhikam mechappeduthaan kazhiyum. aarogya upadesham pankidumbol aarogyaparipalana vidagdhar sweekarikkunna vaakkukal paalikkunnathilum aarogyaparamaya perumattangalilum swaadheenam chelutthiyekkaam, ennirunnaalum, positteev framing (udha.jii.ningal screening nadathukayaanenkil athijeevikkaan saadhyatha mechappedunnu) negatteevu framingine (udha.jii.ningal screening nadathunnillengil marikkanulla saadhyatha kooduthalaanu) prathyeka saahacharyangalil kooduthal falapradamaanu.
saankethikavidya.
telemedicine saankethikavidya mechappedunnathinanusarichu, adutha oafees sandarshanam vare kaathirikkunnathinuparam, rogikale thalsamayam vidooramaayi nireekshikkaanum smartphoneukal polulla vyakthigatha mobail upakaranangal upayogichu shupaarshakalum marunnukalude krameekaranangalum ashayavinimayam nadatthaanum doctormark mikacha kazhivukal undaakumenn 2012 ll pravachikkapettu.
smart medisin boatil toppukal, smart farmacy kuppikal allengil klinikkal trialsil upayogikkunna smart blisttar paakkejukal, krithyamaaya paalikkal daatta aavasyamulla mattu aaplikkeshanukal enniva pole, rogiyude inputt illaathe pravartthikkukayum kuppiyo kuppiyo axus cheytha samayavum theeyathiyum rekhappeduthukayum cheyyuka, allengil oru blisttar paakkejil ninnu marunnu neekkam cheyyuka. propraittari readerukal vazhiyo smartphoneukal allengil tablettukal polulla enfc praapthamakkiya upakaranangal vazhiyo daatta vaayikkaan kazhiyum. atharam upakaranagalkk anusaranaseshi mechappeduthaan kazhiyumennu 2009leeii oru patanam prasthaavichu.
aarogyaparipalana vidagtharum avarude rogikalum thammilulla dvimukha imeyil aashayavinimayathinte falaprapti vendathra vilayiruthappettilla.
mobail phoneukal.
aagola janasamkhyayude 67 sathamaanathinu thulyamaaya 5.15 bilyan aalukalkk mobail upakaranamundu, eee ennam vardhichukondirikkanu. aarogyasamrakshanathil mobail phoneukal upayogikkukayum emhealt enna swantham padam valarthukayum cheythittundu. marunnukalude upayogam mechappeduthunnathilum avar oru punk vahichittundu. udaaharanathinu, aasthma, hypertension thudangiya vittumaaraatha avasthakalulla rogikalil marunnu kazhikkaan rogikale ormmippikkaan tekst sandeshamayakkal upayogikkunnu. kshayarogam kaikaaryam cheiyunnathinaayi nilavil nerittu nireekshikkunna therapy (dott) (aaraan shupaarsha cheiyunnathu) yude resource intensive staanderdinu pakaramaayi sinkranas, asinkranas viidiyoo observed therapy (vottu) ennivaykkaayi smartphoneukalude upayogam mattu udaaharanangalil ulppedunnu. smartphone aaplikkeshanukal, samvedanaathmaka phoon kolukalile shabda thirichariyal, teleformacy enniva marunnukal paalikkunnath mechappeduthunnathinulla mattu aarogya edapedalukalil ulppedunnu. chila avalokanangal sammishra phalangal report cheiyunnundenkilum, aarogyathinte upayogam marunnukalude upayogam mechappeduthukayum chelavu kuranjathaanennum chila phalangal kaanikkunnu. marunnukal paalikkunnath mechappeduthunnathinna emhealt upayogikkunnathu saadhyamaanennum rogikal amgeekarikkumennum padanangal kaanikkunnu. nirddishta mobail aaplikkeshanukalum anusaranathe pinthunaychekkaam. dharikkaavunna wireless gulika censorukal, smart pilboxukal, smart inhalerukal thudangiya mattu telehealth edapedalukalkkoppam emhealt edapedalukalum upayogichittundu.
marunnukalude roopangal.
dippo kuthivayppukal mattu tharatthilulla marunnukale apekshichu pathivayi kazhikkendathilla, koodaathe oru medical professional marunnukalude paripaalanatthil earppettirikkunnathil ithu paalikkal vardhippikkum. doppukal ooral garbhanirodhana gulikakalkkum schisophrenia, bipolar desorder enniva chikilsikkaan upayogikkunna anticycotic marunnukalkkum upayogikkunnu.
balaprayogam.
paalikkal urappakkaan chilappol marunnukal manappoorvvam nalkunnu. oru vyakthi swamedhayaa prathibaddhatha pulartthukayo autpeshyant prathibaddhatha oordarinu vidheyanaakukayo cheythaal ithu sambhavikkam, avide marunnu kazhikkunnathil paraajayappedunnathu thadankalil vaykkaanum swamedhayaa chikitsa nalkaanum idayaakkum. oru rogikk arivodeyulla chikilsaykku sammatham nalkaanulla maanasika sheshi illennu kanakkakkiyaal ithu sambhavikkam.
aarogyavum rogangalum kaikaaryam cheyyuka.
vikasita rajyangalil vittumaaraatha rogangalulla rogikalil 50 sathamaanam perr maathramaan chikilsayude shupaarshakal paalikkunnathenn patana vidagdhar kanakkakkunnu.
aasthmayude paalikkal (lokamembaadum 28-70%) thadayaavunna sandarshanangalum ashupathriyil praveshippikkalum aavasyamulla gurutharamaaya aasthma aakramanangalude saadhyatha vardhippikkunnu; aasthmayude paalikkal prashnangalkk kaaranamaakunnath budhimuttulla inhaler upayogam, marunnukalude paarshwafalangal, chikilsayude chelavu ennivayulppede vividha kaaranangalal aakam.
kyaansar.
oro varshavum yukeyil 200,000 puthiya cancer kesukal kandethunnu. yukeyile muthirnnavaril moonnil oraalkk jeevanu bheeshaniyaakunna cancer undaakukayum oro varshavum 120,000 aalukal avarude cancer moolam marikkukayum cheyyum. yukeyile motham maranangalil 25 sathamaanavum ithaanu. ennirunnaalum, 90 sathamaanam cancer vedana phalapradamaayi chikilsikkaan kazhiyumenkilum, 40 sathamaanam rogikal maathramaan avarude marunnukal paalikkunnath.
aduthide (2016) nadatthiya chittayaya avalokanathinte phalangal rogikalil valiyoru vibhaagam nirddeshichathupole avarude ooral antinoplastic marunnukal kazhikkaan paadupedunnathaayi kandethi. ithu rogiyude vidyaabhyaasam, chikitsa padhathikal avalokanam cheiyunnathinum rekhappeduthunnathinum, rogiyude nireekshanatthinum, prathyekichu veettile cancer chikilsayude vardhanavinoppam avasarangalum velluvilikalum avatharippikkunnu.
ithu paalikkaatthathinte kaaranagal rogikal thaazhepparayunna reethiyil nalkiyittunda
cancer chikilsayil paalikkal nirakk vyathyaasappettirikkunnum chilappol athishayakaramaamvidham moshavumaanennu kaanikkunnathinulla thelivukal partridge "et al" (2002) kandethi. thaazhepparayunna pattika avarude kandethalukalude sangrahamaanu
1998-ll, tamoxifene oru prathirodha ejantaayi vilayiruthunna pareekshanangal ekadesham moonnilonnu dropt nirakk kaanichu
1999 maarchil, aii. dii. 1> vayass prayamaaya sthreekalil anchu varshathekku tamoxifen dainamdina dosinte prabhavam vilayiruthunna "anthaaraashtra stanarbuda edapedal padanatthile anusaranm 
prameham.
prameha rogikalkku coronary hrudrogam varaanulla saadhyatha kooduthalaanu, koodaathe saadhaaranayaayi avarude chikitsa reethikale kooduthal sankeernnamaakkunna anubandha avasthakalundu, udaaharanathinu uyarnna rakthasammardham, ponnatthadi, vishaadam ennivayum anusaranathinte mosham nirakkukal kondu savisheshamaan.
prameha lakshanagal kaikaaryam cheiyunnathilum kadinamaaya marunnu rejimentukale chuttipattiyulla theerumaanamedukkunnathilum svayam falapraptiyum apakadasaadhyatha vilayiruthalum enna aashayamaanu marunnu paalikkal nirakkukale nayikkunna mattu vashangal. manassilakkiya niyanthranavum svayam falapraptiyum parasparam ganyamaayi bandhappettirikkuka mathramalla, pramehatthinte maanasika lakshanangalumayi bandhappettirikkukayum mikacha marunnu paalikkal falangalumaayi nerittu bandhappettirikkukayum cheiyunnu. aarogyavumayi bandhapetta arivu/vishwaasangal, prashnaparihara kazhivukal, svayam niyanthrana kazhivukal ennivayulppede vividha baahya gadakangal prameharogikalude svayam maanejment perumaattangale badhikkunnu, ivayellaam prameha lakshanangalude melulla niyanthranathe badhikkunnu.
koodaathe, prameharogikalkku avarude marunnukal paalikkaathathinulla apakadasaadhyathakale chuttipattiyulla thiranjeduppukalil nayikkunna theerumaanamedukkal prakriyakal manasilaakkendathu pradhaanamaan. rogiyude theerumaana sahayangal (pii. tii. dii. eiii. ezz), vyakthikal avarude aarogya parirakshaa oopshanukalekkurichu theerumaanangal edukkunnathil avarude klinikkanmaarumaayi edapazhakaan sahayikkunna upakaranangalude koottam, theerumaanaparamaaya samgharsham kuraykkunnathinum prameha chikitsa parijnjaanam kaimarunnathu mechappeduthunnathinum roga sankeernathakalkku kooduthal apakadasaadhyatha kaivarikkunnathinum upayogapradamaanu, marunnu paalikkunnathil avayude falaprapti ganyamaayi kuravaanu. athinaal, prameha marunnu paalikkunnathine chuttipattiyulla apakadasaadhyatha dharana theerumaanamedukkal prakriyakalum bahumukhavum saamoohika saambathika prathyaaghaathangalode sankeernavumaanu. udaaharanathinu, prameha phalangalile kudiyetta aarogya asamathvangal amerikkayile videshathu janicha muthirnnavarkkidayil avarude thaddesheeya athiraalikalumaayi thaarathamyappeduthumbol apakadasaadhyatha kuravaayathinaal, ithu kuranja samrakshana jeevithashailiyilekkum pramehathe cherukkunnathinu nirnayakamaaya chikitsa maattangalilekkum nayikkunnu. koodaathe, samayathekkurichulla rogikalude dhaaranayile vyathiyanangal (athaayath.iii. amoorthamaaya prayojanakaramaaya bhaavi falangalkkaayi varthamaanakaalath karsanavum chelaveriyathumaaya marunnukal kazhikkunnath rogikalude pettennullathum kaalathamasamullathumaaya samthrupthikkaayulla mungananakalumaayi vairudhyamundaakkum) prameha marunnukalkk palappozhum chittayaya, pathiv administration aavasyamullathinaal ithu paalikkunnathin gurutharamaaya prathyaaghaathangal undakkaam.
hypertension.
mosham paalikkalinte falamaayi, rakthaathimarddam roganirnnayikkunna 75 sathamaanam rogikalkkum rakthasammardhathinte opttimal niyanthranam nedaan kazhiyilla.
maanasikarogam.
2003 leeii oru avalokanathil, anticycotics nirddeshicha rogikalil <aii. dii. 1> avarkk nirddeshicha marunnu apoorvamaayi allengil ottum kazhikkunnillennu kandethi. chilappol anusarikkathirikkuka ennathu ulkkaazhchayude abhavam moolamaanu, ennaal maanasika vaikalyangal episodic aakam, rogalakshanangal chikilsikkunnathinuparam aavarthana saadhyatha kuraykkunnathinu anticycotics roganirodhanamaayi upayogikkunnu, chila sandarbhangalil anticycotics upayogikkaathe vyakthikalkk kooduthal episodukal undaakilla. 2006 leeii oru avalokanam schisophreniaykkulla compliance therapy phalangal anweshichu schisophrenia anubandha syndromsumulla aalukalkk compliance therapy prayojanakaramaanennu soochippikkunnathinu vyakthamaaya thelivukalonnum kandethiyilla.
rheumatoid aarthraitis.
oru deerghakaala patanam kaanikkunnath chikilsayude anusaranamaanu ekadesham 60 sathamaanam. anusaranathinte pravachanangal sociodemographic allengil klinikkal gadakangalekkaal manashaasthraparavum ashayavinimayaparavum logistic swabhaavamullathumaanennu kandethi. thaazhepparayunna gadakangal anusaranathinte swatantra pravachanangalayi thiricharinju