Journal of Traditional Medical Complementary Therapies

.: ORIGINAL RESEARCH
The Attitudes of Cancer Patients with Nausea and Vomiting Symptoms to Complementary and Holistic Treatments: A Cross-Sectional Study
Bulantı Kusma Semptomu Olan Kanser Hastalarının Tamamlayıcı ve Bütüncül Tedaviye Karşı Tutumları: Bir Kesitsel Çalışma
Dilek YILDIRIMa, Dilek BAYKALb, Burcu DEDEOĞLU DEMİRc
aDepartment of Nursing, İstanbul Aydın University Faculty of Health Sciences, İstanbul, TURKEY
bDepartment of Nursing, İstanbul Atlas University Faculty of Health Sciences, İstanbul, TURKEY
cDepartment of Nursing, İstanbul Arel University Faculty of Health Sciences, İstanbul, TURKEY
J Tradit Complem Med. 2021;4(2):238-45
doi: 10.5336/jtracom.2020-80681
Article Language: EN
Full Text
ABSTRACT
 Objective: The study was performed to determine the attitude of cancer patients with symptoms of nausea and vomiting towards complementary and holistic treatment. Material and Methods: The study sample included the 138 cancer patients with 3 or more nausea and vomiting according to Visual Anolog Scale were included in the study. Information Form, Attitudes towards Holistic Complementary and Alternative Medicine Scale, The Rhodes Index of Nausea, Vomiting, and Retching were used as data collection of this study. Results: Cancer patients were found to have a positive attitude towards complementary and holistic therapy. Although cancer patients participating in the study often experienced nausea and vomiting, symptom distress was also low. There was a positive correlation between symptom frequency and the symptom occurrence and holistic health dimensions (p˂0.05). Moreover, a positive correlation was found between the symptom occurrence of the patients and their attitudes towards alternative medicine (p˂0.05). Conclusion: Cancer patients have a positive attitude towards complementary and holistic therapy in relieving the symptoms of nausea and vomiting. It is recommended to create guidelines for determining effective strategies and using them properly in mixed therapies.

Keywords: Cancer patients; nausea and vomiting; complementary and holistic treatment; attitude evaluation
ÖZET
 Amaç: Bu araştırma, bulantı ve kusma semptomu olan kanser hastalarının, tamamlayıcı ve bütüncül tedaviye karşı tutumlarını belirlemek amacıyla yapıldı. Gereç ve Yöntemler: Çalışma, Vizüel Analog Skalaya göre 3 ve üzerinde bulantı kusması olan ve kanser tanısı alan 138 hastanın katılımı ile gerçekleştirildi. Verilerin toplanmasında Sosyodemografik Bilgi Formu, Bütüncül Tamamlayıcı ve Alternatif Tıbba Karşı Tutum Ölçeği ve Rhodes Bulantı, Kusma ve Öğürme İndeksi kullanıldı. Bulgular: Kanser hastalarının tamamlayıcı ve alternatif tıbba karşı tutumlarının pozitif olduğu belirlendi. Çalışmaya katılan kanser hastalarında bulantı ve kusma görülme sıklığı yüksek olsa da semptom sıkıntısı düşüktü. Semptom deneyimleri ve semptom oluşumlarıyla bütüncül sağlık boyutu arasında pozitif korelasyon belirlendi (p˂0,05). Ayrıca hastaların semptom oluşumlarıyla tamamlayıcı ve alternatif tıbba karşı tutumları arasında pozitif korelasyon saptandı (p˂0,05). Sonuç: Bu araştırmada, bulantı ve kusma semptomu olan kanser hastalarının, tamamlayıcı ve bütüncül tedaviye karşı tutumlarının olumlu olduğu belirlendi. Tamamlayıcı ve bütüncül tedaviye yönelik etkili stratejiler belirlemek ve bunları farmakolojik tedavilerle birlikte doğru kullanmak için kılavuzlar oluşturulması önerilir.

Anahtar Kelimeler: Kanser hastaları; bulantı ve kusma; tamamlayıcı ve bütünleyici tedaviler; tutum değerlendirmesi
REFERENCES:
  1. Ferlay J, Colombet M, Soerjomataram I, Mathers C, Parkin DM, Pi-eros M, et al. Estimating the global cancer incidence and mortality in 2018: GLOBOCAN sources and methods. Int J Cancer. 2019;144(8):1941-53. [PubMed] 
  2. Mayor S. Side-effects of cancer drugs are under-reported in trials. Lancet Oncol. 2015;16(3):e107. [PubMed] 
  3. Beaver CC, Magnan MA. Managing chemotherapy side effects: achieving reliable and equitable outcomes. Clin J Oncol Nurs. 2016;20(6):589-91. [PubMed] 
  4. Navari RM. managing nausea and vomiting in patients with cancer: what works. oncology (Williston Park). 2018;32(3):121-5, 131, 136. [PubMed] 
  5. Razvi Y, Chan S, McFarlane T, McKenzie E, Zaki P, DeAngelis C, et al. ASCO, NCCN, MASCC/ESMO: a comparison of antiemetic guidelines for the treatment of chemotherapy-induced nausea and vomiting in adult patients. Support Care Cancer. 2019;27(1):87-95. [PubMed] 
  6. Saneei Totmaj A, Emamat H, Jarrahi F, Zarrati M. The effect of ginger (Zingiber officinale) on chemotherapy-induced nausea and vomiting in breast cancer patients: A systematic literature review of randomized controlled trials. Phytother Res. 2019;33(8):1957-65. [PubMed] 
  7. Adel N. Overview of chemotherapy-induced nausea and vomiting and evidence-based therapies. Am J Manag Care. 2017;23(14 Suppl):S259-S65. [PubMed] 
  8. Crichton M, Marshall S, Marx W, McCarthy AL, Isenring E. Efficacy of ginger (Zingiber officinale) in ameliorating chemotherapy-induced nausea and vomiting and chemotherapy-related outcomes: a systematic review update and meta-analysis. J Acad Nutr Diet. 2019;119(12):2055-68. [PubMed] 
  9. Mapp CP, Hostetler D, Sable JF, Parker C, Gouge E, Masterson M, et al. Peppermint oil: evaluating efficacy on nausea in patients receiving chemotherapy in the ambulatory setting. Clin J Oncol Nurs. 2020;24(2):160-4. [PubMed] 
  10. Lv C, Shi C, Li L, Wen X, Xian CJ. Chinese herbal medicines in the prevention and treatment of chemotherapy-induced nausea and vomiting. Curr Opin Support Palliat Care. 2018;12(2):174-80. [PubMed] 
  11. Abuelgasim KA, Alsharhan Y, Alenzi T, Alhazzani A, Ali YZ, Jazieh AR. The use of complementary and alternative medicine by patients with cancer: a cross-sectional survey in Saudi Arabia. BMC Complement Altern Med. 2018;18(1):88. [PubMed]  [PMC] 
  12. Buckner CA, Lafrenie RM, Dénommée JA, Caswell JM, Want DA. Complementary and alternative medicine use in patients before and after a cancer diagnosis. Curr Oncol. 2018;25(4):e275-e81. [PubMed]  [PMC] 
  13. Gras M, Vallard A, Brosse C, Beneton A, Sotton S, Guyotat D, et al. Use of complementary and alternative medicines among cancer patients: a single-center study. Oncology. 2019;97(1):18-25. [PubMed] 
  14. Verhoef MJ, Balneaves LG, Boon HS, Vroegindewey A. Reasons for and characteristics associated with complementary and alternative medicine use among adult cancer patients: a systematic review. Integr Cancer Ther. 2005;4(4):274-86. [PubMed] 
  15. Molassiotis A, Fernández-Ortega P, Pud D, Ozden G, Scott JA, Panteli V, et al. Use of complementary and alternative medicine in cancer patients: a European survey. Ann Oncol. 2005;16(4):655-63. [PubMed] 
  16. Liew AC, Peh KK, Tan BS, Zhao W, Tangiisuran B. Evaluation of chemotherapy-induced toxicity and health-related quality of life amongst early-stage breast cancer patients receiving Chinese herbal medicine in Malaysia. Support Care Cancer. 2019;27(12):4515-24. [PubMed] 
  17. Ozturk R, Satir DG, Sevil U. Use of complementary and alternative medicine and attitudes in patients with gynecological cancers. European Journal of Therapeutics. 2016 22(3):141-7. DOI: 10.5152/EurJTher. 2016. 006
  18. Vanaki Z, Matourypour P, Gholami R, Zare Z, Mehrzad V, Dehghan M. Therapeutic touch for nausea in breast cancer patients receiving chemotherapy: Composing a treatment. Complement Ther Clin Pract. 2016;22:64-8. [PubMed] 
  19. Yarney J, Donkor A, Opoku SY, Yarney L, Agyeman-Duah I, Abakah AC, et al. Characteristics of users and implications for the use of complementary and alternative medicine in Ghanaian cancer patients undergoing radiotherapy and chemotherapy: a cross-sectional study. BMC Complement Altern Med. 2013;13:16. [PubMed]  [PMC] 
  20. West HJ. Complementary and Alternative Medicine in Cancer Care. JAMA Oncol. 2018;4(1):139. [PubMed] 
  21. Hyland ME, Lewith GT, Westoby C. Developing a measure of attitudes: the holistic complementary and alternative medicine questionnaire. Complement Ther Med. 2003;11(1):33-8. [PubMed] 
  22. Erci B. Attitudes towards holistic complementary and alternative medicine: a sample of healthy people in Turkey. J Clin Nurs. 2007;16(4):761-8. [PubMed] 
  23. Rhodes VA, McDaniel RW. Nausea, vomiting, and retching: complex problems in palliative care. CA Cancer J Clin. 2001;51(4):232-48 quiz 249-52. Erratum in: CA Cancer J Clin 2001;51(5):320. [Crossref]  [PubMed] 
  24. Genç F. The effects of acupressure on nausea, vomiting and anxiety associated with chemotherapy in breast cancer patients [Doctoral Thesis]. Erzurum: Atatürk University; 2010. [Link] 
  25. Walsh D, Donnelly S, Rybicki L. The symptoms of advanced cancer: relationship to age, gender, and performance status in 1,000 patients. Support Care Cancer. 2000;8(3):175-9. [PubMed] 
  26. Pang L, de la Cruz M, Wu J, Liu D, Naqvi M, Bruera E. Symptom frequency and change of oldest old cancer patients. Support Care Cancer. 2019;27(11):4165-70. [PubMed] 
  27. Miaskowski C, Cooper BA, Paul SM, Dodd M, Lee K, Aouizerat BE, et al. Subgroups of patients with cancer with different symptom experiences and quality-of-life outcomes: a cluster analysis. Oncol Nurs Forum. 2006;33(5):E79-89. [PubMed] 
  28. Booth CM, Clemons M, Dranitsaris G, Joy A, Young S, Callaghan W, et al. Chemotherapy-induced nausea and vomiting in breast cancer patients: a prospective observational study. J Support Oncol. 2007;5(8):374-80. [PubMed] 
  29. Sloan JA, Goldberg RM, Sargent DJ, Vargas-Chanes D, Nair S, Cha SS, et al. Women experience greater toxicity with fluorouracil-based chemotherapy for colorectal cancer. J Clin Oncol. 2002;20(6):1491-8. [PubMed] 
  30. Whorton JC. The history of complementary and alternative medicine. In: Cuellar NG, ed. Conversations in Complementary and Alternative Medicine: Insights and Perspectives From Leading Practitioners. 1st ed. Massachusetts, ABD: Jones and Bartlett Publishers, Inc; 2006. p.1-8. [Link] 
  31. Clarke TC, Black LI, Stussman BJ, Barnes PM, Nahin RL. Trends in the use of complementary health approaches among adults: United States, 2002-2012. Natl Health Stat Report. 2015;(79):1-16. [PubMed]  [PMC] 
  32. Deng G, Cassileth BR. Integrative oncology: complementary therapies for pain, anxiety, and mood disturbance. CA Cancer J Clin. 2005;55(2):109-16. [PubMed] 
  33. Qureshi M, Zelinski E, Carlson LE. Cancer and complementary therapies: current trends in survivors' ınterest and use. Integr Cancer Ther. 2018;17(3):844-53. [PubMed]  [PMC] 
  34. Ernst E, Cassileth BR. The prevalence of complementary/alternative medicine in cancer: a systematic review. Cancer. 1998;83(4):777-82. [PubMed] 
  35. Kav S, Hanoğlu Z, Algıer L. Use of complementary and alternative medicine by cancer patients in Turkey: A literature review. International Journal of Hematology and Oncology 2008;18(1):32-8. [Link] 

.: 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