Journal of Traditional Medical Complementary Therapies

.: REVIEW
Huzursuz Bacak Sendromunda Tamamlayıcı ve İntegratif (Bütünleşik) Yöntemlerin Kullanımı: Geleneksel Derleme
Use of Complementary and Integrative (Integrated) Methods in Restless Legs Syndrome: Traditional Review
Ayser DÖNERa, Sultan TAŞCIa
aErciyes Üniversitesi Sağlık Bilimleri Fakültesi, İç Hastalıkları Hemşireliği ABD, Kayseri, Türkiye
J Tradit Complem Med. 2022;5(1):75-81
doi: 10.5336/jtracom.2021-86484
Article Language: TR
Full Text
ÖZET
 Willis-Ekbom hastalığı olarak da bilinen huzursuz bacak sendromu (HBS); istirahatte ortaya çıkıp hareketle rahatlayan, ekstremitelerde huzursuzluk ve tatsız duyumlarla karakterize, sık görülen nörolojik bir bozukluktur. Literatürde, HBS'nin son dönem böbrek hastalığı, diyabet, Parkinson, multipl skleroz, romatoid artrit gibi bazı hastalıklarda sık görüldüğüne ve bu sendroma bağlı depresyon ve anksiyete bozukluklarını artırdığına, uyku ve yaşam kalitesini olumsuz yönde etkilendiğine ilişkin bilgiler yer almaktadır. HBS belirtilerinin azaltılmasında ve/veya tedavisinde farmakolojik ve integratif (bütünleşik) yöntemlerden yararlanılmaktadır. Farmakolojik tedavi de kullanılan bazı ilaçların, HBS belirtileri üzerinde yararlı etkileri olmasına rağmen bu ilaçlar ciddi komplikasyonlara neden olabilmekte ve HBS belirtilerini daha da artırabilmektedir. Farmakolojik yöntemlerle birlikte kullanılan integratif (bütünleşik) yöntemlerin semptom yönetimini sağlaması, yan etkilerinin olmaması ya da daha az olması, kolay uygulanabilir olması ve ekonomik yük getirmemesi gibi olumlu yönleri vardır. Literatürde, HBS belirtilerinin yönetiminde aromaterapi, masaj, egzersiz, yoga, refleksoloji, akupunktur, sıcak-soğuk uygulama gibi yöntemlerin hastalarda olumlu etkilerinin olduğunu belirten çalışmalar yer almaktadır. Tamamlayıcı ve integratif (bütünleşik) tedavi (TİT) yöntemleri, pek çok alanda olduğu gibi HBS belirtilerinin yönetiminde de kullanılmaktadır. Ancak TİT yöntemlerinin HBS semptom yönetiminde etkililiğini gösteren çalışmalar sınırlı sayıdadır. HBS ile ilişkili hastalığa sahip olan ve risk taşıyan bireylerde, bu sendromun taranarak şiddetinin belirlenmesi, semptom yönetiminde kullanılan TİT yöntemleri ile ilgili çalışmaların yapılması, kanıt temelli uygulamaların kliniğe aktarılması ve bu yöntemlerin kullanımın yaygınlaştırılmasında sağlık profesyonellerine önemli sorumluluklar düşmektedir. Bu derlemenin amacı, sağlık profesyonellerinin HBS semptom yönetiminde kullanılan TİT yöntemleri hakkında bilgi sahibi olmasını sağlamaktır.

Anahtar Kelimeler: Huzursuz bacak sendromu; tamamlayıcı ve integratif yöntemler; sağlık profesyonelleri
ABSTRACT
 Also known as the Willis-Ekbom disease, restless legs syndrome (RLS) is a prevalently observed neurological disorder which occurs during rest and relieved with movement and which is characterized with restlessness and discomfort sensations in the limbs. There is information in the literature that RLS is frequently seen in some diseases such as end-stage kidney disease, diabetes, Parkinson's, multiple sclerosis, and rheumatoid arthritis. The literature has shown that RLS results in increased depression and anxiety disorders, have a negative impact on the quality of sleep and life. Pharmacological and integrative (integrated) methods have been used to reduce and/or treat RLS symptoms. Although some drugs used in pharmacological treatment have beneficial effects on RLS symptoms, these drugs can cause serious complications and increase RLS symptoms. Integrative (integrated) methods used together with pharmacological methods have positive aspects such as providing symptom management, no or less side effects, easy application, and no economic burden. In the literature, there are studies stating that methods such as aromatherapy, massage, exercise, yoga, reflexology, acupuncture, hot-cold application have positive effects on patients in the management of RLS symptoms. Complementary and integrative (integrated) treatment (CIT) methods are used in the management of RLS symptoms, as in many areas. However, studies showing the effectiveness of CIT methods in RLS symptom management are limited. Health professionals have important responsibilities in determining the severity of this syndrome by screening individuals with RLS-related disease and at risk, conducting studies on CIT methods used in symptom management, transferring evidence-based practices to the clinic, and disseminating the use of these methods. The purpose of this review is to provide health professionals with information about CIT methods used in RLS symptom management.

Keywords: Restless leg syndrome; complementary and integrative methods; health professionals
REFERENCES:
  1. Yalınay Dikmen P. Erişkinlerde huzursuz bacaklar sendromu tedavisi: Amerikan Nöroloji Akademisi'nin pratik kılavuz özeti [Restless legs syndrome treatments in adults: practice guideline summary of American Academy of Neurology]. J Turkish Sleep Med. 2017;4:59-64. [Crossref] 
  2. Maung SC, El Sara A, Chapman C, Cohen D, Cukor D. Sleep disorders in chronic kidney disease. World J Nephrol. 2016;5(3):224-32. [Crossref]  [PubMed]  [PMC] 
  3. Özdel O, Toker Uğurlu T. Uyku bozukluğu genetiği [Genetics of sleep disorders]. Turkiye Klinikleri J Psychiatry-Special Topics. 2016;9(1):88-91. [Link] 
  4. Becker PM. Diagnosis of restless leg syndrome (Willis-Ekbom disease). Sleep Med Clin. 2015;10(3):235-40. [Crossref]  [PubMed] 
  5. Giannaki CD, Hadjigeorgiou GM, Karatzaferi C, Pantzaris MC, Stefanidis I, Sakkas GK. Epidemiology, impact, and treatment options of restless legs syndrome in end-stage renal disease patients: an evidence-based review. Kidney Int. 2014;85(6):1275-82. [Crossref]  [PubMed] 
  6. Guo S, Huang J, Jiang H, Han C, Li J, Xu X, et al. Restless legs syndrome: from pathophysiology to clinical diagnosis and management. Front Aging Neurosci. 2017;9:171. [Crossref]  [PubMed]  [PMC] 
  7. Klingelhoefer L, Bhattacharya K, Reichmann H. Restless legs syndrome. Clin Med (Lond). 2016;16(4):379-82. [Crossref]  [PubMed]  [PMC] 
  8. Ohayon MM, O'Hara R, Vitiello MV. Epidemiology of restless legs syndrome: a synthesis of the literature. Sleep Med Rev. 2012;16(4):283-95. [Crossref]  [PubMed]  [PMC] 
  9. Chu L, Chu E, Dogra G, Chakera A. Restless legs syndrome: an underappreciated and distressing problem for haemodialysis patients. Intern Med J. 2014;44(10):1030-3. [Crossref]  [PubMed] 
  10. Akın S, Bölük C, Türk Börü Ü, Taşdemir M, Gezer T, Şahbaz FG, et al. Restless legs syndrome in type 2 diabetes mellitus. Prim Care Diabetes. 2019;13(1):87-91. [Crossref]  [PubMed] 
  11. Yang X, Liu B, Shen H, Li S, Zhao Q, An R, et al. Prevalence of restless legs syndrome in Parkinson's disease: a systematic review and meta-analysis of observational studies. Sleep Med. 2018;43:40-6. [Crossref]  [PubMed] 
  12. Ning P, Hu F, Yang B, Shen Q, Zhao Q, Huang H, et al. Systematic review and meta-analysis of observational studies to understand the prevalence of restless legs syndrome in multiple sclerosis: an update. Sleep Med. 2018;50:97-104. [Crossref]  [PubMed] 
  13. Ishaq M, Sualeh Muhammad J, Hameed K. Risk of restless legs syndrome in low socioeconomic rheumatoid arthritis patients. Mod Rheumatol. 2013;23(4):705-8. [Crossref]  [PubMed] 
  14. Allen RP, Bharmal M, Calloway M. Prevalence and disease burden of primary restless legs syndrome: results of a general population survey in the United States. Mov Disord. 2011;26(1):114-20. [Crossref]  [PubMed] 
  15. Bega D, Malkani R. Alternative treatment of restless legs syndrome: an overview of the evidence for mind-body interventions, lifestyle interventions, and neutraceuticals. Sleep Med. 2016;17:99-105. [Crossref]  [PubMed] 
  16. Allen RP, Picchietti DL, Garcia-Borreguero D, Ondo WG, Walters AS, Winkelman JW, et al. Restless legs syndrome/Willis-Ekbom disease diagnostic criteria: updated International Restless Legs Syndrome Study Group (IRLSSG) consensus criteria--history, rationale, description, and significance. Sleep Med. 2014;15(8):860-73. [Crossref]  [PubMed] 
  17. Allen RP, Picchietti D, Hening WA, Trenkwalder C, Walters AS, Montplaisi J. Restless legs syndrome: diagnostic criteria, special considerations, and epidemiology workshop at the National Institutes of Health. Sleep Med. 2003;4(2):101-19. [Crossref]  [PubMed] 
  18. Walters AS, Aldrich MS, Allen R, Ancoli-Israel S, Buchholz D, Chokroverty S, et al. Toward a better definition of the restless legs syndrome. Mov Disord. 1995;10(5):634-42. [Crossref]  [PubMed] 
  19. Yılmaz NH, Çelik N, Akbostancı MC. Huzursuz bacak sendromu tedavisinde kanıta dayalı tıp uygulamaları [Evidence-based medicine in the treatment of restless leg syndrome]. Park Hast ve Hareket Bozuklukları Derg. 2017;20(1-2):16-27. [Crossref] 
  20. Mitchell UH. Nondrug-related aspect of treating Ekbom disease, formerly known as restless legs syndrome. Neuropsychiatr Dis Treat. 2011;7(1):251-7. [Crossref]  [PubMed]  [PMC] 
  21. Bilgilisoy Filiz M, Çakır T. Güncel tanı kriterleri ile huzursuz bacak sendromu [Restless legs syndrome with current diagnostic criteria]. Türk Osteoporoz Derg. 2015;21(2):87-95. [Crossref] 
  22. Winkelman JW, Armstrong MJ, Allen RP, Chaudhuri KR, Ondo W, Trenkwalder C, et al. Practice guideline summary: treatment of restless legs syndrome in adults: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology. Neurology. 2016;87(24):2585-93. [Crossref]  [PubMed]  [PMC] 
  23. Döner A, Taşcı S. Effect of massage therapy with lavender oil on severity of restless legs syndrome and quality of life in hemodialysis patients. J Nurs Scholarsh. 2021; Nov 14. [Crossref]  [PubMed] 
  24. Mirbagher-Ajorpaz N, Rahemi Z, Aghajani M, Hashemi SH. Effects of glycerin oil and lavender oil massages on hemodialysis patients' restless legs syndrome. J Bodyw Mov Ther. 2020;24(1):88-92. [Crossref]  [PubMed] 
  25. Nasiri M, Abbasi M, Khosroabadi Yousefi Z, Saghafi H, Hamzeei F, Amiri MH, et al. Short-term effects of massage with olive oil on the severity of uremic restless legs syndrome: a double-blind placebo-controlled trial. Complement Ther Med. 2019;44:261-8. [Crossref]  [PubMed] 
  26. Russell M. Massage therapy and restless legs syndrome. J Bodyw Mov Ther. 2007;11(2):146-50. [Crossref] 
  27. Song YY, Hu RJ, Diao YS, Chen L, Jiang XL. Effects of exercise training on restless legs syndrome, depression, sleep quality, and fatigue among hemodialysis patients: a systematic review and meta-analysis. J Pain Symptom Manage. 2018;55(4):1184-95. [Crossref]  [PubMed] 
  28. Giannaki CD, Sakkas GK, Karatzaferi C, Hadjigeorgiou GM, Lavdas E, Kyriakides T, et al. Effect of exercise training and dopamine agonists in patients with uremic restless legs syndrome: a six-month randomized, partially double-blind, placebo-controlled comparative study. BMC Nephrol. 2013;14:194. [Crossref]  [PubMed]  [PMC] 
  29. Aliabadi AZ, Mirhosseini Z, Rastaghi S, Rad M. Comparison of the effect of cold dialysate versus stretching exercises on severity of restless legs syndrome in patients undergoing hemodialysis: a randomized controlled trial. Evid Based Care J. 2020;10(3):14-22. [Crossref] 
  30. Innes KE, Selfe TK. The effects of a gentle yoga program on sleep, mood, and blood pressure in older women with restless legs syndrome (RLS): a preliminary randomized controlled trial. Evid Based Complement Alternat Med. 2012;2012:294058. [Crossref]  [PubMed]  [PMC] 
  31. Innes KE, Selfe TK, Montgomery C, Hollingshead N, Huysmans Z, Srinivasan R, et al. Effects of a 12-week yoga versus a 12-week educational film intervention on symptoms of restless legs syndrome and related outcomes: an exploratory randomized controlled trial. J Clin Sleep Med. 2020;16(1):107-19. [Crossref]  [PubMed]  [PMC] 
  32. Ghasemi M, Rejeh N, Heravi-Karimooi M, Tadrisi SD, Samady Kia P. The effectiveness of foot reflexology in the severity of restless legs syndrome in female patients undergoing dialysis: a randomized controlled trial. Crit Care Nurs J. 2018;11(2):e68945. [Crossref] 
  33. Abbasi Fakhravari A, Bastani F, Haghani H. The effect of foot reflexology massage on the sleep quality of elderly women with restless leg syndrome. J Client-Centered Nurs Care. 2018;4(2):96-103. [Crossref] 
  34. Pan W, Wang M, Li M, Wang Q, Kwak S, Jiang W, et al. Actigraph evaluation of acupuncture for treating restless legs syndrome. Evid Based Complement Alternat Med. 2015;2015:343201. [Crossref]  [PubMed]  [PMC] 
  35. Raissi GR, Forogh B, Ahadi T, Ghahramanpoori S, Ghaboussi P, Sajadi S. Evaluation of acupuncture in the treatment of restless legs syndrome: a randomized controlled trial. J Acupunct Meridian Stud. 2017;10(5):346-50. [Crossref]  [PubMed] 
  36. Park A, Ambrogi K, Hade EM. Randomized pilot trial for the efficacy of the MMF07 foot massager and heat therapy for restless legs syndrome. PLoS One. 2020;15(4):e0230951. [Crossref]  [PubMed]  [PMC] 
  37. Jafarimanesh H, Vakilian K, Mobasseri S. Thermo-therapy and cryotherapy to decrease the symptoms of restless leg syndrome during the pregnancy: a randomized clinical trial. Complement Ther Med. 2020;50:102409. [Crossref]  [PubMed] 
  38. Wali S, Shukr A, Boudal A, Alsaiari A, Krayem A. The effect of vitamin D supplements on the severity of restless legs syndrome. Sleep Breath. 2015;19(2):579-83. [Crossref]  [PubMed] 
  39. Sagheb MM, Dormanesh B, Fallahzadeh MK, Akbari H, Sohrabi Nazari S, Heydari ST, et al. Efficacy of vitamins C, E, and their combination for treatment of restless legs syndrome in hemodialysis patients: a randomized, double-blind, placebo-controlled trial. Sleep Med. 2012;13(5):542-5. [Crossref]  [PubMed] 
  40. Heide AC, Winkler T, Helms HJ, Nitsche MA, Trenkwalder C, Paulus W, et al. Effects of transcutaneous spinal direct current stimulation in idiopathic restless legs patients. Brain Stimul. 2014;7(5):636-42. [Crossref]  [PubMed] 
  41. Wang L, Liu C, Hou Y, Zhan S, Zhang Z, Wang J, et al. Altered cortical gray matter volume and functional connectivity after transcutaneous spinal cord direct current stimulation in idiopathic restless legs syndrome. Sleep Med. 2020;74:254-61. [Crossref]  [PubMed] 
  42. Abraham L, Lasch K, Patrick J, Piault E, Tully S, Treglia M. Living with restless legs syndrome: the patient's perspective. J Sleep Res. 2010;19(2):249. [Crossref] 
  43. Harrison EG, Keating JL, Morgan PE. The experience of living with restless legs syndrome: a qualitative study. J Health Psychol. 2021;26(8):1154-67. [Crossref]  [PubMed] 
  44. Varela MJV, Coin-Carvalho JE, Carvalho LBC, Varela MV, Potasz C, Prado LBF, et al. Restless legs syndrome: a qualitative analysis of psychosocial suffering and interdisciplinary attention. J Health Psychol. 2013;18(10):1341-52. [Crossref]  [PubMed] 
  45. Giannaki CD, Hadjigavriel M, Lazarou A, Michael A, Damianou L, Atmatzidis E, et al. Restless legs syndrome is contributing to fatigue and low quality of life levels in hemodialysis patients. World J Nephrol. 2017;6(5):236-42. [Crossref]  [PubMed]  [PMC] 
  46. Xu XM, Liu Y, Jia SY, Dong MX, Cao D, Wei YD. Complementary and alternative therapies for restless legs syndrome: an evidence-based systematic review. Sleep Med Rev. 2018;38:158-67. [Crossref]  [PubMed] 
  47. National Association for Holistic Aromatherapy [Internet]. © 2022 National Association for Holistic Aromatherapy. [Erişim tarihi: 17 Ocak 2021]. What is aromatherapy? Erişim linki: [Link] 
  48. Gnatta JR, Kurebayashi LFS, Turrini RNT, da Silva MJP. [Aromatherapy and nursing: historical and theoretical conception]. Rev Esc Enferm USP. 2016;50(1):130-6. [Crossref]  [PubMed] 
  49. Buckle J. Clinical Aromatherapy Essential Oils in Healthcare. 3rd ed. St. Louis: Elsevier; 2015. [Crossref] 
  50. Manion CR, Widder RM. Essentials of essential oils. Am J Health Syst Pharm. 2017;74(9):e153-62. [Crossref]  [PubMed] 
  51. Turan N, Öztürk A, Kaya N. Hemşirelikte yeni bir sorumluluk alanı: tamamlayıcı terapi [A new responsibility in nursing: complementary therapy]. Maltepe Üniversitesi Hemşirelik Bilim ve Sanatı Derg. 2010;3(1):103-8. [Link] 
  52. Özveren H. Ağrı kontrolünde farmakolojik olmayan yöntemler [Non-pharmacological methods at pain management]. Hacettepe Üniversitesi Sağlık Bilim Fakültesi Hemşirelik Derg. 2011;18(1):83-92. [Link] 
  53. Taş D, Akyol A. Egzersiz ve kronik böbrek yetmezliği [Exercise and chronic renal failure]. Türk Nefroloji, Diyaliz ve Transplantasyon Hemşireleri Derneği Nefroloji Hemşireliği Dergisi. 2017;1(12):10-9. [Link] 
  54. Başer M, Taşcı S. Kanıta Dayalı Rehberleriyle Tamamlayıcı ve Destekleyici Uygulamalar. 1. Baskı. Ankara: Akademisyen Kitabevi; 2015.
  55. Embong NH, Soh YC, Ming LC, Wong TW. Revisiting reflexology: concept, evidence, current practice, and practitioner training. J Tradit Complement Med. 2015;5(4):197-206. [Crossref]  [PubMed]  [PMC] 
  56. Micunovic I. Origin of Chinese medicine, acupuncture & moxibustion. J Altern Complement Integr Med. 2018;4(2):054. [Crossref] 
  57. Ovayolu Ö, Ovayolu N. Palyatif bakım alan kanser hastalarının ağrı yönetiminde integratif yaklaşımlar [Integrative approaches in pain management of cancer patients with palyative care]. Hacettepe Üniversitesi Hemşirelik Fakültesi Derg. 2017;4(3):54-64. [Link] 
  58. Erden S, Çelik SŞ. Bir elektro analjezi yöntemi: transkütan elektriksel sinir stimülasyonu ve hemşirenin rolleri [An electroanalgesia method: transcutaneous electrical nerve stimulation and nurses' role]. Hacettepe Üniversitesi Hemşirelik Fakültesi Derg. 2015;2(1):50-60. [Link] 

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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