Turkiye Klinikleri Journal of Dermatology

.: ORIGINAL RESEARCH
Anxiety, Pain and Quality of Life Among Patients Undergoing Nail Surgery: A Prospective, Cross-sectional Study
Tırnak Cerrahisinde Anksiyete, Ağrı ve Yaşam Kalitesinin Değerlendirilmesi: Prospektif, Kesitsel Bir Çalışma
Vildan MANAVa, Müge GÖRE KARAALİb, Ozan ERDEMc, Asude KARA POLATa, Duygu ERDİLa, Ayşe Esra KOKU AKSUa
aDepartment of Dermatology, University of Health Sciences İstanbul Training and Research Hospital, İstanbul, TURKEY
bDepartment of Dermatology, Erzincan Binali Yıldırım University Mengücek Gazi Training and Research Hospital, Erzincan, TURKEY
cClinic of Dermatology, Başakşehir Çam ve Sakura State Hospital, İstanbul, TURKEY
Turkiye Klinikleri J Dermatol. 2021;31(2):100-8
doi: 10.5336/dermato.2021-81657
Article Language: EN
Full Text
ABSTRACT
 Objective: Nail surgery is a part of dermatological surgery and can cause a lot of anxiety in patients. This study aims to determine the anxiety and pain levels of the patients in nail surgery procedure steps and to assess their effects on their lives. Material and Methods: Patients aged >14 years admitted to our outpatient clinic between April 2019-2020 and scheduled for nail surgery were included in the study. Anxiety (State and Trait Anxiety Scale), dermatological quality of life (Skindex-16), and pain (Visual Analog Scale 0-10) were recorded before and after nail surgery. Results: The patients were most worried about the recurrence of their disease after the procedure (54.17%). Skindex-16 scores in the 31-50 age group were statistically significantly higher than in the other age groups. Preoperative anxiety scores were higher in male patients compared to females (p=0.021). Preoperative anxiety was significantly lower in patients who had previous nail surgery (p=0.018). Preoperative pain scores were negatively correlated with preoperative anxiety (p=0.048). Conclusion: Nail surgery is a procedure that can cause anxiety and stress for patients. Being aware of the anxiety and pain of patients due to surgery and the factors affecting them by the dermatologic surgeon can change the attitudes and behaviors towards patients, and the measures to be taken for anxiety and pain can accelerate the recovery of patients.

Keywords: Life quality; nail surgery; anxiety; pain; Visual Analog Scale
ÖZET
 Amaç: Tırnak cerrahisi, dermatolojik cerrahinin bir parçasıdır ve hastalarda çok fazla anksiyeteye neden olabilir. Bu çalışmanın amacı, hastaların tırnak cerrahisi öncesinde, sırasında ve sonrasında anksiyete ve ağrı düzeylerini ve yaşam kaliteleri üzerindeki etkilerini belirlemektir. Gereç ve Yöntemler: Nisan 2019 ve 2020 tarihleri arasında polikliniğimize başvuran ve tırnak cerrahisi planlanan 14 yaş üstü hastalar çalışmaya dâhil edildi. Tırnak cerrahisi öncesinde, sırasında ve sonrasında anksiyete (Anlık ve Sürekli Kaygı Ölçeği), dermatolojik yaşam kalitesi (Skindex-16) ve ağrı (Vizüel Analog Skala 0-10) kaydedildi. Bulgular: Hastalar en çok işlem sonrası hastalıklarının nüksetmesinden endişe duyuyorlardı (%54,17). 31-50 yaş grubundaki Skindex-16 puanları diğer yaş gruplarından istatistiksel olarak anlamlı derecede yüksekti. Erkek hastalarda kadınlara göre ameliyat öncesi anksiyete puanları daha yüksekti (p=0,021). Daha önce tırnak cerrahisi geçiren hastalarda cerrahi öncesi anksiyete anlamlı olarak daha düşüktü (p=0,018). Preoperatif ağrı skorları ile preoperatif anksiyete arasında negatif korelasyon vardı (p=0,048). Sonuç: Tırnak cerrahisi, hastalar için anksiyete ve strese neden olabilen bir işlemdir. Cerrah tarafından hastaların ameliyata bağlı anksiyete ve ağrılarının ve onları etkileyen faktörlerin farkında olmak hastalara yönelik tutum ve davranışları değiştirebilir, anksiyete ve ağrı için alınacak önlemler hastalarda yara iyileşmesini hızlandırabilir.

Anahtar Kelimeler: Yaşam kalitesi; tırnak cerrahisi; anksiyete; ağrı; Vizüel Analog Skala
REFERENCES:
  1. Bailey L. Strategies for decreasing patient anxiety in the perioperative setting. AORN J. 2010;92(4):445-57 quiz 458-60. Erratum in: AORN J. 2010;92(6):708. [Crossref]  [PubMed] 
  2. Bellani ML. Psychological aspects in day-case surgery. Int J Surg. 2008;6 Suppl 1:S44-6. [Crossref]  [PubMed] 
  3. Shenefelt PD. Anxiety reduction using hypnotic induction and self-guided imagery for relaxation during dermatologic procedures. Int J Clin Exp Hypn. 2013;61(3):305-18. [Crossref]  [PubMed] 
  4. Vachiramon V, Sobanko JF, Rattanaumpawan P, Miller CJ. Music reduces patient anxiety during Mohs surgery: an open-label randomized controlled trial. Dermatol Surg. 2013;39(2):298-305. [Crossref]  [PubMed] 
  5. Ravitskiy L, Phillips PK, Roenigk RK, Weaver AL, Killian JM, Hoverson Schott A, et al. The use of oral midazolam for perioperative anxiolysis of healthy patients undergoing Mohs surgery: conclusions from randomized controlled and prospective studies. J Am Acad Dermatol. 2011;64(2):310-22. [Crossref]  [PubMed] 
  6. Patakfalvi L, Benohanian A. Needle-free anaesthesia, a promising option for the needle-phobic patient. Br J Dermatol. 2014; 170(5):1191-2. [Crossref]  [PubMed] 
  7. Spielberger CD, Gorsuch RL, Lushene RE. Manual for the State-Trait Anxiety Inventory. Palo Alto. CA: Consulting Psychologists Press; 1970. [Link] 
  8. Öner N, Le Compte VA. Durumluk-Sürekli Kaygı Envanteri El Kitabı. 2. Baskı. İstanbul, Turkey: Bogazici University; 1985. [Link] 
  9. Aksu AEK, Saraçoğlu ZN, Sabuncu İ, Chren MM, Tozun M. [Validity and reliability of the Turkish version of the Skindex-16]. Turkderm. 2016;50(3):109. [Crossref] 
  10. DeLauro NM, DeLauro TM. Onychocryptosis. Clin Podiatr Med Surg. 2004;21(4):617-30, vii. [Crossref]  [PubMed] 
  11. Shivarathre DG, Howard N, Krishna S, Cowan C, Platt SR. Psychological factors and personality traits associated with patients in chronic foot and ankle pain. Foot Ankle Int. 2014;35(11):1103-7. [Crossref]  [PubMed] 
  12. Becerro de Bengoa Vallejo R, Losa Iglesias ME, Alou Cervera L, Sevillano Fernández D, Prieto Prieto J. Total nail ablation for onychodystrophy with optimized gauze-phenol application. JEADV. 2010;24(8):936-42. [Crossref]  [PubMed] 
  13. Baran R. The nail in the elderly. Clin Dermatol. 2011;29(1):54-60. [Crossref]  [PubMed] 
  14. Jansen P, Stoffels I, Müseler AC, Petri M, Brinker TJ, Schedlowski M, et al. Salivary cortisol levels and anxiety in melanoma patients undergoing sentinel lymph node excision under local anesthesia versus general anesthesia: a prospective study. World J Surg Oncol. 2020;18(1):53. [Crossref]  [PubMed]  [PMC] 
  15. Kuivalainen AM, Pitkäniemi J, Widenius T, Elonen E, Rosenberg P. Anxiety and pain during bone marrow aspiration and biopsy. Scand J Pain. 2012;3(2):92-6. [Crossref]  [PubMed] 
  16. Miller LS, Shelby RA, Balmadrid MH, Yoon S, Baker JA, Wildermann L, et al. Patient anxiety before and immediately after imaging-guided breast biopsy procedures: impact of radiologist-patient communication. J Am Coll Radiol. 2013;10(6):423-31. [Crossref]  [PubMed] 
  17. Göktay F, Altan ZM, Talas A, Akpınar E, Özdemir EÖ, Aytekin S. Anxiety among patients undergoing nail surgery and skin punch biopsy: effects of age, gender, educational status, and previous experience. J Cutan Med Surg. 2016;20(1):35-9. [Crossref]  [PubMed] 
  18. Borges APP, Pelafsky VPC, Miot LDB, Miot HA. Quality of life with ingrown toenails: a cross-sectional study. Dermatol Surg. 2017; 43(5):751-3. [Crossref]  [PubMed] 
  19. Becerro de Bengoa Vallejo R, López López D, Palomo López P, Soriano Medrano A, Morales Ponce Á, Losa Iglesias ME. Quality of life improvement in aged patients after toenail surgery. Z Gerontol Geriatr. 2019;52(8):789-94. [Crossref]  [PubMed] 
  20. Chren MM, Lasek RJ, Sahay AP, Sands LP. Measurement properties of Skindex-16: a brief quality-of-life measure for patients with skin diseases. J Cutan Med Surg. 2001;5(2):105-10. [Crossref]  [PubMed] 
  21. Cooke M, Chaboyer W, Schluter P, Hiratos M. The effect of music on preoperative anxiety in day surgery. J Adv Nurs. 2005;52(1):47-55. [Crossref]  [PubMed] 
  22. Augustin M, Zschocke I, Godau N, Buske-Kirschbaum A, Peschen M, Sommer B, et al. Skin surgery under local anesthesia leads to stress-induced alterations of psychological, physical, and immune functions. Dermatol Surg. 1999;25(11):868-71. [Crossref]  [PubMed] 
  23. Hayes Balmadrid MA, Shelby RA, Wren AA, Miller LS, Yoon SC, Baker JA, et al. Anxiety prior to breast biopsy: Relationships with length of time from breast biopsy recommendation to biopsy procedure and psychosocial factors. J Health Psychol. 2017;22(5):561-71. [Crossref]  [PubMed] 
  24. Lebel S, Jakubovits G, Rosberger Z, Loiselle C, Seguin C, Cornaz C, et al. Waiting for a breast biopsy. Psychosocial consequences and coping strategies. J Psychosom Res. 2003;55(5):437-43. [Crossref]  [PubMed] 
  25. Wetsch WA, Pircher I, Lederer W, Kinzl JF, Traweger C, Heinz-Erian P, et al. Preoperative stress and anxiety in day-care patients and inpatients undergoing fast-track surgery. Br J Anaesth. 2009;103(2):199-205. Erratum in: Br J Anaesth. 2010;105(6):878. [Crossref]  [PubMed] 
  26. Alacadag M, Cilingir D. Presurgery anxiety and day surgery patients' need for information. J Perianesth Nurs. 2018;33(5):658-68. [Crossref]  [PubMed] 
  27. Ozalp G, Sarioglu R, Tuncel G, Aslan K, Kadiogullari N. Preoperative emotional states in patients with breast cancer and postoperative pain. Acta Anaesthesiol Scand. 2003;47(1):26-9. [Crossref]  [PubMed] 
  28. Keogh E, Barlow C, Mounce C, Bond FW. Assessing the relationship between cold pressor pain responses and dimensions of the anxiety sensitivity profile in healthy men and women. Cogn Behav Ther. 2006;35(4):198-206. [Crossref]  [PubMed] 
  29. van Wijk AJ, Makkes PC. Highly anxious dental patients report more pain during dental injections. Br Dent J. 2008;205(3):E7; discus sion 142-3. [Crossref]  [PubMed] 
  30. Robleda G, Sillero-Sillero A, Puig T, Gich I, Ba-os JE. Influence of preoperative emotional state on postoperative pain following orthopedic and trauma surgery. Rev Lat Am Enfermagem. 2014;22(5):785-91. [Crossref]  [PubMed]  [PMC] 
  31. McCall JG, Al-Hasani R, Siuda ER, Hong DY, Norris AJ, Ford CP, et al. CRH engagement of the locus coeruleus noradrenergic system mediates stress-induced anxiety. Neuron. 2015;87(3):605-20. [Crossref]  [PubMed]  [PMC] 

.: Up To Date

.: Process List

Login

 Forgot your password?

 New Registration  

Contact

Ortadoğu Reklam Tanıtım Yayıncılık Turizm Eğitim İnşaat Sanayi ve Ticaret A.Ş.

.: Address

Turkocagi Caddesi No:30 06520 Balgat / ANKARA
Phone: +90 312 286 56 56
Fax: +90 312 220 04 70
E-mail: info@turkiyeklinikleri.com

.: Manuscript Editing Department

Phone: +90 312 286 56 56/ 2
E-mail: yaziisleri@turkiyeklinikleri.com

.: English Language Redaction

Phone: +90 312 286 56 56/ 145
E-mail: tkyayindestek@turkiyeklinikleri.com

.: Marketing Sales-Project Department

Phone: +90 312 286 56 56/ 142
E-mail: reklam@turkiyeklinikleri.com

.: Subscription and Public Relations Department

Phone: +90 312 286 56 56/ 118
E-mail: abone@turkiyeklinikleri.com

.: Customer Services

Phone: +90 312 286 56 56/ 118
E-mail: satisdestek@turkiyeklinikleri.com

1. TERMS OF USE

1.1. To use the web pages with http://www.turkiyeklinikleri.com domain name or the websites reached through the sub domain names attached to the domain name (They will be collectively referred as "SITE"), please read the conditions below. If you do not accept these terms, please cease to use the "SITE." "SITE" owner reserves the right to change the information on the website, forms, contents, the "SITE," "SITE" terms of use anytime they want.

1.2. The owner of the "SITE" is Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. (From now on it is going to be referred as "Turkiye Klinikleri", shortly) and it resides at Turkocagi cad. No:30, 06520 Balgat Ankara. The services in the "SITE" are provided by "Turkiye Klinikleri."

1.3. Anyone accessing the "SITE" with or without a fee whether they are a natural person or a legal identity is considered to agree these terms of use. In this contract hereby, "Turkiye Klinikleri" may change the stated terms anytime. These changes will be published in the "SITE" periodically and they will be valid when they are published. Any natural person or legal identity benefiting from and reaching to the "SITE" are considered to be agreed to any change on hereby contract terms done by "Turkiye Klinikleri."

1.4. The "Terms of Use" hereby is published in the website with the last change on March 30th 2014 and the "SITE" is activated by enabling the access to everyone. The "Terms of Use" hereby is also a part of the any "USER Contract" was and/or will be done with the users using "Turkiye Klinikleri" services with or without a fee an inseparable.

2. DEFINITIONS

2.1. "SITE": A website offering different kind of services and context with a certain frame determined by "Turkiye Klinikleri" and it is accessible on-line on http://www.turkiyeklinikleri.com domain name and/or subdomains connected to the domain name.

2.2. USER: A natural person or a legal identity accessing to the "SITE" through online settings.

2.3. LINK: A link enabling to access to another website through the "SITE", the files, the context or through another website to the "SITE", the files and the context.

2.4. CONTEXT: Any visual, literary and auditory images published in the "Turkiye Klinikleri", "SITE" and/or any website or any accessible information, file, picture, number/figures, price, etc.

2.5. "USER CONTRACT": An electronically signed contract between a natural or a legal identity benefiting from special services "Turkiye Klinikleri" will provide and "Turkiye Klinikleri".

3. SCOPE OF THE SERVICES

3.1. "Turkiye Klinikleri" is completely free to determine the scope and quality of the services via the "SITE".

3.2. To benefit the services of "Turkiye Klinikleri" "SITE", the "USER" must deliver the features that will be specified by "Turkiye Klinikleri". "Turkiye Klinikleri" may change this necessity any time single-sided.

3.3. Not for a limited number, the services "Turkiye Klinikleri" will provide through the "SITE" for a certain price or for free are;

- Providing scientific articles, books and informative publications for health industry.

- Providing structural, statistical and editorial support to article preparation stage for scientific journals.

4. GENERAL PROVISIONS

4.1. "Turkiye Klinikleri" is completely free to determine which of the services and contents provided in the "SITE" will be charged.

4.2. People benefiting from the services provided by "Turkiye Klinikleri" and using the website can use the "SITE" only according to the law and only for personal reasons. Users have the criminal and civil liability for every process and action they take in the "SITE". Every USER agrees, declares and undertakes that they will not proceed by any function or action infringement of rights of "Turkiye Klinikleri"s and/or other third parties', they are the exclusive right holder on usage, processing, storage, made public and revealing any written, visual or auditory information reported to Turkiye Klinikleri" and/or "SITE" to the third parties. "USER" agrees and undertakes that s/he will not duplicate, copy, distribute, process, the pictures, text, visual and auditory images, video clips, files, databases, catalogs and lists within the "SITE", s/he will not be using these actions or with other ways to compete with "Turkiye Klinikleri", directly or indirectly.

4.3. The services provided and the context published within the "SITE" by third parties is not under the responsibility of "Turkiye Klinikleri", institutions collaborated with "Turkiye Klinikleri", "Turkiye Klinikleri" employee and directors, "Turkiye Klinikleri" authorized salespeople. Commitment to accuracy and legality of the published information, context, visual and auditory images provided by any third party are under the full responsibility of the third party. "Turkiye Klinikleri" does not promise and guarantee the safety, accuracy and legality of the services and context provided by a third party.

4.4. "USER"s cannot act against "Turkiye Klinikleri", other "USER"s and third parties by using the "SITE". "Turkiye Klinikleri" has no direct and/or indirect responsibility for any damage a third party suffered or will suffer regarding "USER"s actions on the "SITE" against the rules of the hereby "Terms of Use" and the law.

4.5. "USER"s accept and undertake that the information and context they provided to the "SITE" are accurate and legal. "Turkiye Klinikleri" is not liable and responsible for promising and guaranteeing the verification of the information and context transmitted to "Turkiye Klinikleri" by the "USER"s, or uploaded, changed and provided through the "SITE" by them and whether these information are safe, accurate and legal.

4.6. "USER"s agree and undertake that they will not perform any action leading to unfair competition, weakening the personal and commercial credit of "Turkiye Klinikleri" and a third party,  encroaching and attacking on personal rights within the "SITE" in accordance with the Turkish Commercial Code Law.

4.7. "Turkiye Klinikleri" reserves the right to change the services and the context within the "SITE"  anytime. "Turkiye Klinikleri" may use this right without any notification and timelessly. "USER"s have to make the changes and/or corrections "Turkiye Klinikleri" required immediately. Any changes and/or corrections that are required by "Turkiye Klinikleri", may be made by "Turkiye Klinikleri" when needed. Any harm, criminal and civil liability resulted or will result from changes and/or corrections required by "Turkiye Klinikleri" and were not made on time by the "USER"s belongs completely to the users.

4.8. "Turkiye Klinikleri" may give links through the "SITE" to other websites and/or "CONTEXT"s and/or folders that are outside of their control and owned and run by third parties. These links are provided for ease of reference only and do not hold qualification for support the respective web SITE or the admin or declaration or guarantee for the information inside. "Turkiye Klinikleri" does not hold any responsibility over the web-sites connected through the links on the "SITE", folders and context, the services or products on the websites provided through these links or their context.

4.9. "Turkiye Klinikleri" may use the information provided to them by the "USERS" through the "SITE" in line with the terms of the "PRIVACY POLICY" and "USER CONTRACT". It may process the information or classify and save them on a database. "Turkiye Klinikleri" may also use the USER's or visitor's identity, address, e-mail address, phone number, IP number, which sections of the "SITE" they visited, domain type, browser type, date and time information to provide statistical evaluation and customized services.

5. PROPRIETARY RIGHTS

5.1. The information accessed through this "SITE" or provided by the users legally and all the elements (including but not limited to design, text, image, html code and other codes) of the "SITE" (all of them will be called as studies tied to "Turkiye Klinikleri"s copyrights) belongs to "Turkiye Klinikleri". Users do not have the right to resell, process, share, distribute, display or give someone permission to access or to use the "Turkiye Klinikleri" services, "Turkiye Klinikleri" information and the products under copyright protection by "Turkiye Klinikleri". Within hereby "Terms of Use" unless explicitly permitted by "Turkiye Klinikleri" nobody can reproduce, process, distribute or produce or prepare any study from those under "Turkiye Klinikleri" copyright protection.

5.2. Within hereby "Terms of Use", "Turkiye Klinikleri" reserves the rights for "Turkiye Klinikleri" services, "Turkiye Klinikleri" information, the products associated with "Turkiye Klinikleri" copyrights, "Turkiye Klinikleri" trademarks, "Turkiye Klinikleri" trade looks or its all rights for other entity and information it has through this website unless it is explicitly authorized by "Turkiye Klinikleri".

6. CHANGES IN THE TERMS OF USE

"Turkiye Klinikleri" in its sole discretion may change the hereby "Terms of Use" anytime announcing within the "SITE". The changed terms of the hereby "Terms of Use" will become valid when they are announced. Hereby "Terms of Use" cannot be changed by unilateral declarations of users.

7. FORCE MAJEURE

"Turkiye Klinikleri" is not responsible for executing late or never of this hereby "Terms of Use", privacy policy and "USER Contract" in any situation legally taken into account as force majeure. Being late or failure of performance or non-defaulting of this and similar cases like this will not be the case from the viewpoint of "Turkiye Klinikleri", and "Turkiye Klinikleri" will not have any damage liability for these situations. "Force majeure" term will be regarded as outside of the concerned party's reasonable control and any situation that "Turkiye Klinikleri" cannot prevent even though it shows due diligence. Also, force majeure situations include but not limited to natural disasters, rebellion, war, strike, communication problems, infrastructure and internet failure, power cut and bad weather conditions.

8. LAW AND AUTHORISATION TO FOLLOW

Turkish Law will be applied in practicing, interpreting the hereby "Terms of Use" and managing the emerging legal relationships within this "Terms of Use" in case of finding element of foreignness, except for the rules of Turkish conflict of laws. Ankara Courts and Enforcement Offices are entitled in any controversy happened or may happen due to hereby contract.

9. CLOSING AND AGREEMENT

Hereby "Terms of Use" come into force when announced in the "SITE" by "Turkiye Klinikleri". The users are regarded to agree to hereby contract terms by using the "SITE". "Turkiye Klinikleri" may change the contract terms and the changes will be come into force by specifying the version number and the date of change on time it is published in the "SITE".

 

30.03.2014

Privacy Policy

We recommend you to read the terms of use below before you visit our website. In case you agree these terms, following our rules will be to your favor. Please read our Terms of Use thoroughly.

www.turkiyeklinikleri.com website belongs to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. and is designed in order to inform physicians in the field of health

www.turkiyeklinikleri.com cannot reach to user’s identity, address, service providers or other information. The users may send this information to the website through forms if they would like to. However, www.turkiyeklinikleri.com may collect your hardware and software information. The information consists of your IP address, browser type, operating system, domain name, access time, and related websites. www.turkiyeklinikleri.com cannot sell the provided user information (your name, e-mail address, home and work address, phone number) to the third parties, publish it publicly, or keep it in the website. Gathered information has a directing feature to be a source for the website’s visitor profile, reporting and promotion of the services.

www.turkiyeklinikleri.com uses the taken information:

-To enhance, improve and maintain the quality of the website

-To generate visitor’s profile and statistical data

-To determine the tendency of the visitors on using our website

-To send print publications/correspondences

-To send press releases or notifications through e-mail

-To generate a list for an event or competition

By using www.turkiyeklinikleri.com you are considered to agree that;

-Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. cannot be hold responsible for any user’s illegal and immoral behavior,

-Terms of use may change from time to time,

-It is not responsible for other websites’ contents it cannot control or the harms they may cause although it uses the connection they provided.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. may block the website to users in the following events:

-Information with wrong, incomplete, deceiving or immoral expressions is recorded to the website,

-Proclamation, advertisement, announcement, libelous expressions are used against natural person or legal identity,

-During various attacks to the website,

-Disruption of the website because of a virus.

Written, visual and audible materials of the website, including the code and the software are under protection by legal legislation.

Without the written consent of Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. the information on the website cannot be downloaded, changed, reproduced, copied, republished, posted or distributed.

All rights of the software and the design of the website belong to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. will be pleased to hear your comments about our terms of use. Please share the subjects you think may enrich our website or if there is any problem regarding our website.

info@turkiyeklinikleri.com