Journal of Traditional Medical Complementary Therapies

.: REVIEW
Kupa Tedavisine Genel Bir Bakış
An Overview of Cupping Treatment
Hakan PARLAKPINARa,b, Seyhan POLATa
aİnönü Üniversitesi Tıp Fakültesi, Tıbbi Farmakoloji ABD, Malatya, TÜRKİYE
bİnönü Üniversitesi Tıp Fakültesi, Turgut Özal Tıp Merkezi, Malatya, TÜRKİYE
J Tradit Complem Med. 2020;3(2):246-64
doi: 10.5336/jtracom.2019-72649
Article Language: TR
Full Text
ÖZET
 Kupa tedavisi, binlerce yıllık uygulanma geçmişi ve bilgi birikimiyle günümüze ulaşmış, koruyucu ve tedavi edici özellikli tamamlayıcı tıp uygulamalarından birisidir. Günümüzde kupa tedavisi dünyanın birçok farklı bölgesinde yaygın bir şekilde uygulanmaktadır. Bazı Avrupa ülkelerinde kupa tedavisi, konvansiyonel sağlık sistemine dâhil edilmiştir. Romatoid artrit, hipertansiyon, baş ağrısı, fibromiyalji, bel ağrısı, osteoartrit, miyofasiyal ağrı sendromu ve infertilite gibi birçok farklı endikasyonda tedavi amacıyla ve sağlıklı bireylerde immün sistemi güçlendirmek için kupa tedavisi uygulanabilmektedir. Geniş bir yelpazedeki tıbbi endikasyonlarda uygulanabilen kupa tedavisinin analjezik, anti-inflamatuar, antioksidan vb. birçok etkiye aracılık ettiği düşünülen farklı görüşler ortaya atılmıştır. Taibah teorisi, kapı kontrol teorisi, diffüz noksiyöz inhibitör kontroller, refleks zon teorisi, β-endorfin ve adrenokortikal hormonların salınımı, immün sistem aktivasyonu, nitrik oksit teorisi, dolaşımın detoksifikasyonu teorisi, oksidatif stresin azaltılması, miyofasiyal dekompresyon ve plasebo etkinlik öne sürülen mekanizmalardandır. Literatürde, kupa tedavisinin deneysel ve klinik etkililiğini, güvenliliğini ve etki mekanizmalarını derinlemesine tartışan çalışmaların sayısı yeterli değildir. Bu bağlamda, kupa tedavisinde altta yatan mekanizmalar, ortaya atılan bazı teorilere rağmen henüz tam olarak aydınlatılamamıştır. Özetle bu derlemede kupa tedavisinin tarihi, güncel sınıflaması, ileri sürülen etki mekanizmaları ve kullanıldığı hastalıklar güncel literatür verilerinin kılavuzluğunda anlatılmış olup bu uygulamayla ilgili ülkemizdeki yasal durum ifade edilmiştir. Kupa tedavisinin bilimsel yönleriyle tam olarak anlaşılabilmesi için iyi dizayn edilmiş ileri klinik çalışmalara ihtiyaç olduğu iyi bilinen bir gerçektir.

Anahtar Kelimeler: Ağrı; tamamlayıcı tedaviler; kupa tedavisi; hacamat; bağışıklık; oksidatif stres
ABSTRACT
 Cupping therapy is one of the traditional and complementary medicine applications that have survived for thousands of years with its history and knowledge. Today, cupping therapy is widely used in many different regions of the world. In some European countries, cupping therapy has been included in the conventional health system. Cupping therapy can be used for the treatment of many different indications such as rheumatoid arthritis, hypertension, headache, fibromyalgia, low back pain, osteoarthritis, myofascial pain syndrome, and infertility and also it can be used for strengthening the immune system in healthy individuals. Taibah theory, gate control theory, diffuse noxious inhibitory controls, reflex zone theory, the release of β-endorphin and adrenocortical hormones, immune system activation, nitric oxide theory, circulatory detoxification theory, oxidative stress reduction, myofascial decompression and placebo activity are suggested mechanisms. In the literature, the number of studies that discuss the experimental and clinical efficacy, safety, and mechanism of action of cupping therapy in depth is not sufficient. Based on this relationship, the underlying mechanisms of cupping therapy have not been fully elucidated, despite some theories. To summarize, in this review; history and current classification of cupping therapy, the proposed mechanisms of action and the diseases in which it is used are explained with the guidance of the current literature and the legal situation in our country related to this practice is expressed. To fully understand the scientific aspects of cupping therapy, it is well known that there is a need for well-designed, advanced clinical trials.

Keywords: Pain; complementary therapies; cupping treatment; hijama; immunity; oxidative stress
REFERENCES:
  1. Okumuş M. [Cupping Therapy and]. Ankara Med J. 2016;16(4):370-82. [Crossref] 
  2. Qureshi NA, Ali GI, Abushanab TS, El-Olemy AT, Alqaed MS, El-Subai IS, et al. History of cupping (Hijama): a narrative review of literature. J Integr Med. 2017;15(3):172-81. [Crossref]  [PubMed] 
  3. Parapia LA. History of bloodletting by phlebotomy. Br J Haematol. 2008;143(4):490-5. [Crossref]  [PubMed] 
  4. Parlar Z. [Bloodletting (Al-hijaamah) in one of the Old Anatolian Turkish Medical Texts: Kitâb-ı Kehhâl-nâme-i Nurü'l-Uyûn] IntJCSS. 2016;2(2):140-7.
  5. Sakin O, Okutan Y, Koçer D, Yıldız M. [Health protection, causes of diseases and essential drugs]. 15. Yüzyıl Türkçe Tıp Kitabı Yâdigâr-ı İbn-i Şerîf. 2. Baskı. İstanbul: Merkezefendi Geleneksel Tıp Derneği; 2017. p.71-72.
  6. Boratav PN. 100 Soruda Türk Folkloru. 2.Baskı. İstanbul: Gerçek yayınevi; 1984. p.272.
  7. Ahmadi A, Schwebel DC, Rezaei M. The efficacy of wet-cupping in the treatment of tension and migraine headache. Am J Chin Med. 2008;36(1):37-44. [Crossref]  [PubMed] 
  8. Cao H, Han M, Li X, Dong S, Shang Y, Wang Q et al. Clinical research evidence of cupping therapy in China: a systematic literature review. BMC Complement Altern Med. 2010;10:70. [Crossref]  [PubMed]  [PMC] 
  9. Anjum N, Jamil S, Hannan A, Akhtar J, Ahmad B. Clinical efficacy of Hijamat (cupping) in Waja-ul-Mafasil (Arthritis). Indian Journal of Traditional Knowledge. 2005;4(4):412-5.
  10. Cao H, Li X, Liu J. An updated review of the efficacy of cupping therapy. PLoS One. 2012;7(2):e31793. [Crossref]  [PubMed]  [PMC] 
  11. Michalsen A, Bock S, Lüdtke R, Rampp T, Baecker M, Bachmann J et al. Effects of traditional cupping therapy in patients with carpal tunnel syndrome: a randomized controlled trial. J Pain. 2009;10(6):601-8. [Crossref]  [PubMed] 
  12. Salomonsen LJ, Skovgaard L, La Cour S, Nyborg L, Launsø L, Fønnebø V. Use of complementary and alternative medicine at Norwegian and Danish hospitals. BMC Complement Altern Med. 2011;11:4. [Crossref]  [PubMed]  [PMC] 
  13. Eisenberg DM, Davis RB, Ettner SL, Appel S, Wilkey S, Van Rompay M, et al. Trends in alternative medicine use in the United States, 1990-1997: results of a follow-up national survey. JAMA. 1998;280(18):1569-75. [Crossref]  [PubMed] 
  14. Musumeci G. Could cupping therapy be used to improve sports performance? J Funct Morphol Kinesiol. 2016;1(1):373-7. [Crossref] 
  15. Al-Bedah AM, Aboushanab TS, Alqaed MS, Qureshi NA, Suhaibani I, Ibrahim G, et al. Classification of cupping therapy: a tool for modernization and standardization. Journal of Complementary and Alternative Medical Research. 2016;1(1):1-10. [Crossref] 
  16. Cao H, Zhu C, Liu J. Wet cupping therapy for treatment of herpes zoster: a systematic review of randomized controlled trials. Altern Ther Health Med. 2010;16(6):48-54. [PubMed] 
  17. Ahmed SM, Madbouly NH, Maklad SS, Abu-Shady EA. Immunomodulatory effects of blood letting cupping therapy in patients with rheumatoid arthritis. Egypt J Immunol. 2005;12(2):39-51. [PubMed] 
  18. Winkes MB, Hoogeveen AR, Houterman S, Giesberts A, Wijn PF, Scheltinga MR. Compartment pressure curves predict surgical outcome in chronic deep posterior compartment syndrome. Am J Sports Med. 2012;40(8):1899-905. [Crossref]  [PubMed] 
  19. Tham LM, Lee HP, Lu C. Cupping: from a biomechanical perspective. J Biomech. 2006;39(12):2183-93. [Crossref]  [PubMed] 
  20. Chirali IZ. Traditional Chinese Medicine Cupping Therapy-e-book. 3rd ed. UK-London: Elsevier Health Sciences; 2014. p.372 [Crossref] 
  21. Teut M, Kaiser S, Ortiz M, Roll S, Binting S, Willich SN et al. Pulsatile dry cupping in patients with osteoarthritis of the knee-a randomized controlled exploratory trial. BMC Complement Altern Med. 2012;12:184. [Crossref]  [PubMed]  [PMC] 
  22. Duh F-C. Development of an innovative medical cupping device. AJER. 2016;5(10):53-8.
  23. Huang T, Zhang W, Huang X, Tian Y, Wang G, Zhang Y, et al. Comparing the efficacy of traditional fire-cupping and high-tech vacuum-cupping using laser doppler imaging at an acupuncture clinic in Beijing. Med Acupunct. 2011;23(1):13-8. [Crossref] 
  24. Karadağ S, Taşcı S, Doğan N, Demir H, Kılıç Z. Application of heat and a home exercise program for pain and function levels in patients with knee osteoarthritis: a randomized controlled trial. Int J Nurs Pract. 2019;25(5):e12772. [Crossref]  [PubMed] 
  25. Duh F-C, Chiu Y-H. Vacuum cupping under various negative pressures: an experimental investigation. JMEST. 2015;2(7):1907-11.
  26. Anees S, Arafath Y, Naaz A, Qaiser KM. Hijamah (Cupping therapy) as a preventive medicine-a retro-prospective analytical study. International Journal of AYUSH. 2015;4(2):88-100.
  27. Wu X, Hu H, Guo L, Wang H. Clinical observation of post-herpetic neuralgia treated with TCM herbal cupping therapy. Zhongguo Zhen Jiu. 2013;33(2):141-4. [PubMed] 
  28. Lin ML, Wu HC, Hsieh YH, Su CT, Shih YS, Lin CW, et al. Evaluation of the effect of laser acupuncture and cupping with ryodoraku and visual analog scale on low back pain. Evid Based Complement Alternat Med. 2012;2012:521612. [Crossref]  [PubMed]  [PMC] 
  29. Al-Rubaye KQA. The clinical and histological skin changes after the cupping therapy (Al-Hijamah). J Turk Acad Dermatol. 2012;6(1):1261a1. [Crossref] 
  30. Lacey JM, Tershakovec AM, Foster GD. Acupuncture for the treatment of obesity: a review of the evidence. Int J Obes Relat Metab Disord. 2003;27(4):419-27. [Crossref]  [PubMed] 
  31. El Sayed SM, Mahmoud HS, Nabo MMH. Methods of wet cupping therapy (al-hijamah): in light of modern medicine and prophetic medicine. Altern Integr Med. 2013;2(3):1-16. [Crossref] 
  32. Saladin KS. Anatomy & Physiology: The Unity of Form and Function. 7th ed. McGraw Hill Education; 2014. p.1248
  33. Theml H, Diem H, Haferlach T. Color Atlas of Hematology: Practical Microscopic and Clinical Diagnosis. 2nd rev. ed. New York: Thieme Flexibook; 2004. p.208 [Crossref] 
  34. Mustafa LA, Dawood RM, Al-Sabaawy OM. Effect of wet cupping on serum lipids profile levels of hyperlipidemic patients and correlation with some metal ions. Raf J Sci. 2012;23(3):128-36.
  35. Melzack R, Wall PD. Pain mechanisms: a new theory. Science. 1965;150(3699):971-9. [Crossref]  [PubMed] 
  36. Esener Z. [Pain (types, pathways, theories, mediators and receptors]. Ondokuzmayıs Tıp Derg. 1983;2(2):191-202.
  37. Al-Bedah AMN, Elsubai IS, Qureshi NA, Aboushanab TS, Ali GIM, El-Olemy AT, et al. The medical perspective of cupping therapy: effects and mechanisms of action. J Tradit Complement Med. 2018;9(2):90-7. [Crossref]  [PubMed]  [PMC] 
  38. Le Bars D, Villanueva L, Bouhassira D, Willer JC. Diffuse noxious inhibitory controls (DNIC) in animals and in man. Patol Fiziol Eksp Ter. 1992;9(4):55-65. [PubMed] 
  39. Lett A. Reflex Zone Therapy For Health Professionals. 1st ed. London: Churchill Livingstone; 2000. p.299.
  40. Sato A, Sato Y, Schmidt RF. The impact of somatosensory input on autonomic functions. Rev Physiol Biochem Pharmacol. 1997;130:1-328. [PubMed] 
  41. Shaban T. Cupping Therapy Encyclopedia. 2nd ed. CreateSpace Independent Publishing Platform: 2018. p.244.
  42. Chirali IZ. Beden ve Ruh Sağlığı için Kupa Terapisi. Yıldız S, çeviri editörü. 1. Baskı. Antalya: Kongre Tıp Kitabevi; 2019. p.116.
  43. Slominski A, Wortsman J, Mazurkiewicz JE, Matsuoka L, Dietrich J, Lawrence K, et al. Detection of proopiomelanocortin-derived antigens in normal and pathologic human skin. J Lab Clin Med. 1993;122(6):658-66. [PubMed] 
  44. Khodorova A, Navarro B, Jouaville LS, Murphy J-E, Rice FL, Mazurkiewicz JE et al. Endothelin-B receptor activation triggers an endogenous analgesic cascade at sites of peripheral injury. Nat Med. 2003;9(8):1055-61. [Crossref]  [PubMed] 
  45. Katzung BG, Trevor AJ. Basic & Clinical Pharmacology. 14th ed. New York: McGraw-Hill Education; 2015. p.1265.
  46. Shaban T. Professional Guide to Cupping Therapy. 1st ed. CreateSpace Independent Publishing Platform: 2009. p.122.
  47. Barak O, Treat JR, James WD. Antimicrobial peptides: effectors of innate immunity in the skin. Adv Dermatol. 2005;21:357-74. [Crossref]  [PubMed] 
  48. El-Domyati M, Saleh F, Barakat M, Mohamed N. Evaluation of cupping therapy in some dermatoses. Egyptian Dermatology Online Journal. 2013;9(1):1-15.
  49. Schäffer MR, Tantry U, van Wesep RA, Barbul A. Nitric oxide metabolism in wounds. J Surg Res. 1997;71(1):25-31. [Crossref]  [PubMed] 
  50. Philippu A. Nitric oxide: a universal modulator of brain function. Curr Med Chem. 2016;23(24):2643-52. [Crossref]  [PubMed] 
  51. Alshowafi FK. Effect of blood cupping on some biochemical parameter. Med J Cairo Univ. 2010;78(1):311-5.
  52. Gok S, Kazanci FH, Erdamar H, Gokgoz N, Hartiningsih S, Dane S. Is it possible to remove heavy metals from the body by wet cupping therapy (al-hijamah)? Indian Journal of Traditional Knowledge. 2016;15(4):700-4.
  53. Tagil SM, Celik HT, Ciftci S, Kazanci FH, Arslan M, Erdamar N, et al. Wet-cupping removes oxidants and decreases oxidative stress. Complement Ther Med. 2014;22(6): 1032-36. [Crossref]  [PubMed] 
  54. Schieber M, Chandel NS. ROS function in redox signaling and oxidative stress. Curr Biol. 2014;24(10):R453-62. [Crossref]  [PubMed]  [PMC] 
  55. Umar NK, Tursunbadalov S, Surgun S, Welcome MO, Dane S. The effects of wet cupping therapy on the blood levels of some heavy metals: a pilot study. J Acupunct Meridian Stud. 2018;11(6):375-9. [Crossref]  [PubMed] 
  56. Alp H, Yerlikaya FH. Investigation of the levels of heavy metal in the blood and venous blood and microRNA levels in women with migraine. SSRN. 2019. [Crossref] 
  57. Ojo OO, Leake DS. Low density lipoprotein oxidation by ferritin at lysosomal pH. Chem Phys Lipids. 2018; 217: 51-7. [Crossref]  [PubMed] 
  58. Koskenkorva-Frank TS, Weiss G, Koppenol WH, Burckhardt S. The complex interplay of iron metabolism, reactive oxygen species, and reactive nitrogen species: insights into the potential of various iron therapies to induce oxidative and nitrosative stress. Free Radic Biol Med. 2013;65:1174-94. [Crossref]  [PubMed] 
  59. El-Shanshory M, Hablas NM, Shebl Y, Fakhreldin AR, Attia M, Almaramhy HH, et al. Al-hijamah (wet cupping therapy of prophetic medicine) significantly and safely reduces iron overload and oxidative stress in thalassemic children: a novel pilot study. J Blood Med. 2018; 9: 241-51. [Crossref]  [PubMed]  [PMC] 
  60. Ersoy S, Altinoz E, Benli AR, Erdemli ME, Aksungur Z, Bag HG, et al. Investigation of wet cupping therapy's effect on oxidative stress based on biochemical parameters. Eur J Integr Med. 2019;30:100946. [Crossref] 
  61. Palekar TJ, Kamthe RS. Comparative effect of myofascial decompression using electrotherapeutic vacuum therapy and mechanical vacuum therapy in non-specific low back pain among housekeeping staffs - a pilot study. International Journal of Basic and Applied Research. 2019;9(5):365-71.
  62. Požgain I, Požgain Z, and Degmečić D. Placebo and nocebo effect: a mini-review. Psychiatr Danub. 2014;26(2):100-7. [PubMed] 
  63. Yıldız S, Eriş S, Polat NY, Yıldız ÜG, Kurt BB, Kurt Y, et al. [A method of healing in traditional Chinese medicine - 2 mechanism of action for cupping therapy: review]. Turkish Journal of Integrative Medicine. 2013;1(1):18-21.
  64. Lahiri M, Santosa A, Teoh LK, Clayton JA, Lim SY, Teng GG, et al. Use of complementary and alternative medicines is associated with delay to initiation of disease‐modifying anti‐rheumatic drug therapy in early inflammatory arthritis. Int J Rheum Dis. 2017:20(5):567-75. [Crossref]  [PubMed] 
  65. Aleyeidi NA, Aseri KS, Matbouli SM, Sulaiamani AA, Kobeisy SA et al. Effects of wet-cupping on blood pressure in hypertensive patients: a randomized controlled trial. J Integr Med. 2015;13(6):391-9. [Crossref]  [PubMed] 
  66. Al-Tabakha MM, Sameer FT, Saeed MH, Batran RM, Abouhegazy NT, Farajallah AA. Evaluation of bloodletting cupping therapy in the management of hypertension. J Pharm Bioallied Sci. 2018;10(1):1-6. [Crossref]  [PubMed]  [PMC] 
  67. Benli AR, Sunay D. Changing efficacy of wet cupping therapy in migraine with lunar phase: a self-controlled interventional study. Med Sci Monit. 2017;23:6162-7. [Crossref]  [PubMed]  [PMC] 
  68. Kaki A, Sawsan R, Samiha M, Al Jaouni S, Elalah MA, Ibrahim N. Wet cupping reduces pain and ımproves health-related quality of life among patients with migraine: a prospective observational study. Oman Med J. 2019;34(2):105-9. [Crossref]  [PubMed]  [PMC] 
  69. Cao H, Hu H, Colagiuri B, Liu J. Medicinal cupping therapy in 30 patients with fibromyalgia: a case series observation. Forsch Komplementmed. 2011;18(3):122-6. [Crossref]  [PubMed] 
  70. Lauche R, Spitzer J, Schwahn B, Ostermann T, Bernardy K, Cramer H, et al. Efficacy of cupping therapy in patients with the fibromyalgia syndrome-a randomised placebo controlled trial. Sci Rep. 2016;6:37316. [Crossref]  [PubMed]  [PMC] 
  71. Cao H, Liu J, Lewith GT. Traditional Chinese medicine for treatment of fibromyalgia: a systematic review of randomized controlled trials. J Altern Complement Med. 2010; 16 (4): 397-409. [Crossref]  [PubMed]  [PMC] 
  72. Cao H, Liu J, Li T, Zhou L, Hu H. Cupping therapy for fibromyalgia: interim results from a partially randomized patient preference study. Integrative Medicine Research. 2015;4(1):14. [Crossref] 
  73. Li CD, Fu XY, Jiang ZY, Yang XG, Huang SQ, Wang QF, et al. Clinical study on combination of acupuncture, cupping and medicine for treatment of fibromyalgia syndrome. Zhongguo Zhen Jiu. 2006;26(1):8-10. [PubMed] 
  74. Jang ZY, Li CD, Qiu L, Guo JH, He LN, Yue Y et al. Combination of acupuncture, cupping and medicine for treatment of fibromyalgia syndrome: a multi-central randomized controlled trial. Zhongguo Zhen Jiu. 2010;30(4):265-9. [PubMed] 
  75. Wang YT, Qi Y, Tang FY, Li FM, Li QH, Xu CP et al. The effect of cupping therapy for low back pain: a meta-analysis based on existing randomized controlled trials. J Back Musculoskelet Rehabil. 2017;30(6):1187-95. [Crossref]  [PubMed] 
  76. Huang CY, Choong MY, Li TS. Effectiveness of cupping therapy for low back pain: a systematic review. Acupunct Med. 2013; 31 (3): 336-7. [Crossref]  [PubMed] 
  77. Kim JI, Kim TH, Lee MS, Kang JW, Kim KH, Choi JY et al. Evaluation of wet-cupping therapy for persistent non-specific low back pain: a randomised, waiting-list controlled, open-label, parallel-group pilot trial. Trials. 2011;12(1):146. [Crossref]  [PubMed]  [PMC] 
  78. Mardani-Kivi M, Montazar R, Azizkhani M, Hashemi-Motlagh K. Wet-cupping is effective on persistent nonspecific low back pain: a randomized clinical trial. Chin J Integr Med. 2019;25(7):502-6. [Crossref]  [PubMed] 
  79. Moura CC, Chaves ÉCL, Cardoso ACLR, Nogueira DA, Corrêa HP, Chianca TCM. Cupping therapy and chronic back pain: systematic review and meta-analysis. Rev Lat Am Enfermagem. 2018;26:e3094. [Crossref]  [PubMed] 
  80. Li JQ, Guo W, Sun ZG, Huang QS, Lee EY, Wang Y, et al. Cupping therapy for treating knee osteoarthritis: the evidence from systematic review and meta-analysis. Complement Ther Clin Pract. 2017;28:152-60. [Crossref]  [PubMed] 
  81. Khan AA, Jahangir U, Urooj S. Management of knee osteoarthritis with cupping therapy. J Adv Pharm Technol Res. 2013; 4 (4): 217-23. [Crossref]  [PubMed]  [PMC] 
  82. Wang YL, An CM, Song S, Lei FL, Wang Y. Cupping therapy for knee osteoarthritis: a synthesis of evidence. Complement Med Res. 2018; 25:249-55. [Crossref]  [PubMed] 
  83. Nasb M, Qun X, Ruckmal Withanage CR, Lingfeng X, Hong C. Dry cupping, ischemic compression, or their combination for the treatment of trigger points: a pilot randomized trial. J Altern Complement Med. 2019;26(1):44-50. [Crossref]  [PubMed]  [PMC] 
  84. Zhao H. [Clinical observation on the therapeutic effect of cupping combined with acupuncture stimulation at trigger points for lumbar myofascial pain syndrome]. Zhen Ci Yan Jiu. 2016;39(4):324-8. [PubMed] 
  85. Abduljabbar H, Gazzaz A, Mourad S, Oraif A. Hijama (wet cupping) for female infertility treatment: a pilot study. IJRCOG. 2016;5(11):3799-801. [Crossref] 
  86. Wang JX, Yang Y, Song Y, Ma LX. positive effect of acupuncture and cupping in ınfertility treatment. Med Acupunct. 2018;30(2):96-9. [Crossref]  [PubMed]  [PMC] 
  87. Sahraeian M, Ershadpour R, Sobhanian S, Jahromi Rasekh A, Kargar Z. Application of cupping therapy in treatment of infertilities resulting from PCOS. Journal of Jahrom University of Medical Sciences. 2014;11:156.

.: 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