Turkiye Klinikleri Journal of Health Sciences

.: ORIGINAL RESEARCH
Gebelerde Huzursuz Bacak Sendromunun Yorgunluk Düzeyi ve Uyku Kalitesi ile İlişkisi: Tanımlayıcı Bir Çalışma
The Relationship Between Restless Leg Syndrome and Fatigue Level and Sleep Quality in Pregnant Women: A Descriptive Study
Hava MAZREKa, Hacer ALAN DİKMENa
aSelçuk Üniversitesi Sağlık Bilimleri Fakültesi, Ebelik ABD, Konya, Türkiye
Turkiye Klinikleri J Health Sci. 2022;7(2):403-11
doi: 10.5336/healthsci.2021-85362
Article Language: TR
Full Text
ÖZET
Amaç: Bu araştırma, gebelerde huzursuz bacak sendromunun yorgunluk düzeyi ve uyku kalitesi ile ilişkisinin incelenmesi amacıyla gerçekleştirilmiştir. Gereç ve Yöntemler: Tanımlayıcı türde olan çalışmanın verileri, Kasım 2019-Nisan 2020 tarihleri arasında kişisel bilgi formu, Huzursuz Bacak Sendromu Tanı Formu, Huzursuz Bacak Sendromu Şiddeti Derecelendirme Skalası, Pittsburgh Uyku Kalitesi İndeksi ve Yorgunluk İçin Görsel Benzerlik Ölçeği ile 228 gebeden toplandı. Verilerin analizinde sayı, yüzde, ortalama ve standart sapma, çarpıklık ve basıklık, t-testi, Mann-Whitney U testi ('post hoc' analizi Tukey HSD), Pearson ve Spearman korelasyon analiz kullanılmıştır. Bulgular: Çalışmada, gebelerin %61,2'sinde huzursuz bacak sendromu saptandı. Gebelerin %32,1'inin orta şiddette huzursuz bacak sendromu yaşadığı belirlendi. Gebelerde huzursuz bacak sendromu varlığı, Pittsburgh Uyku Kalitesi İndeksi ve enerji alt boyutu arasında anlamlı bir fark vardı (p=0,01). Gebelerde huzursuz bacak sendromu şiddeti ile Pittsburgh Uyku Kalitesi İndeksi (p=0,002), yorgunluk (p=0,007) ve enerji (p=0,005) alt boyutu arasında anlamlı fark vardı. Gebelerin, Pittsburgh Uyku Kalitesi İndeksi puan ortalaması ile yorgunluk alt boyutu arasında orta düzeyde, pozitif yönlü (p<0,001), enerji alt boyutu ile zayıf düzeyde, negatif yönlü (p=0,007) anlamlı ilişki vardı. Sonuç: Gebelerde huzursuz bacak sendromu, yorgunluk ve uyku düzeyi arasında ilişki olduğu tespit edilmiştir. Ebeler, gebeleri huzursuz bacak sendromu açısından takip etmeli, huzursuz bacak sendromu olan gebelerin yorgunluk düzeyi ve uyku kalitesini değerlendirmelidir.

Anahtar Kelimeler: Gebe kadınlar; huzursuz bacak sendromu; yorgunluk; uyku
ABSTRACT
Objective: This study was conducted to examine the relationship between restless legs syndrome, fatigue level and sleep quality in pregnant women. Material and Methods: Data of the descriptive study were collected from 228 pregnant women with a personal information form, Restless Leg Syndrome Diagnosis Form, Restless Leg Syndrome Severity Rating Scale, Pittsburgh Sleep Quality Index and Visual Analog Scale for Fatigue, between November 2019-April 2020. In the analysis of the data, number, percentage, mean and standard deviation, skewness and kurtosis, t-test, Mann-Whitney U test (post hoc analysis Tukey HSD), and Pearson and Spearman correlation analysis were used. Results: Restless leg syndrome was detected in 61.2% of the pregnant women. It was determined that 32.1% of the pregnant women experienced moderate restless leg syndrome severity. The was a significant difference between the presence of restless leg syndrome and Pittsburgh Sleep Quality Index and energy sub-dimension scores (p=0.01). There was a significant difference between restless leg syndrome severity and Pittsburgh Sleep Quality Index (p=0.002), fatigue (p=0.007), and energy (p=0.005) subscales in the pregnant women. There was a moderate, positive (p<0.001) relationship between the Pittsburgh Sleep Quality Index scores of the pregnant women and the fatigue subscale, and a weak, negative (p=0.007) relationship with the energy subscale. Conclusion: It was found that there is a relationship between restless leg syndrome and fatigue and sleep level in pregnant women. Midwives should follow the pregnant women in terms of restless leg syndrome, and they should definitely evaluate the fatigue level and sleep quality of pregnant women with restless leg syndrome.

Keywords: Pregnant women; restless leg syndrome; fatigue; sleep
REFERENCES:
  1. Aydın Ş, Özdemir C. The relationship between restless legs syndrome and anxiety, depression, and quality of life. South Clin Ist Euras. 2019;30(2):124-9. [Crossref] 
  2. Sforza E, Roche F, Pichot V. Determinants of nocturnal cardiovascular variability and heart rate arousal response in restless legs syndrome (RLS)/periodic limb movements (PLMS). J Clin Med. 2019;8(10):1619. [Crossref]  [PubMed]  [PMC] 
  3. Filiz MB, Çakır T. Güncel tanı kriterleri ile huzursuz bacak sendromu [Restless legs syndrome with current diagnostic criteria]. Türk Osteoporoz Dergisi.2015;21:87-95. [Crossref] 
  4. Seeman MV. Why are women prone to restless legs syndrome? Int J Environ Res Public Health. 2020;17(1):368. [Crossref]  [PubMed]  [PMC] 
  5. Şahin FK, Köken G, Coşar E, Solak Ö, Saylan F, Fidan F, et al. Gebelerde huzursuz bacak sendromu sıklığı [The incidence of restless leg syndrome in pregnancy]. Journal of Turkish Obstetric and Gynecology Society. 2007;4(4): 246-9. [Link] 
  6. Alan Dikmen H. Gebelerde huzursuz bacak sendromunun uyku kalitesi ve kaygı düzeyi üzerine etkisi [The effect of restless leg syndrome in pregnant women on sleep quality and anxiety level]. ACU Sağlık Bil Derg. 2021;12(1):132-8. [Link] 
  7. Sevim S, Dogu O, Camdeviren H, Bugdayci R, Sasmaz T, Kaleagasi H, et al. Unexpectedly low prevalence and unusual characteristics of RLS in Mersin, Turkey. Neurology. 2003;61(11):1562-9. [Crossref]  [PubMed] 
  8. Manconi M, Govoni V, De Vito A, Economou NT, Cesnik E, Casetta I, et al. Restless legs syndrome and pregnancy. Neurology. 2004; 63(6):1065-9. [Crossref]  [PubMed] 
  9. Bai G, Korfage IJ, Groen EH, Jaddoe VW, Mautner E, Raat H. Associations between Nausea, Vomiting, Fatigue and Health-Related Quality of Life of Women in Early Pregnancy: The Generation R Study. PLoS One. 2016;11(11):e0166133. [Crossref]  [PubMed]  [PMC] 
  10. Giallo R, Gartland D, Woolhouse H, Brown S. "I didn't know it was possible to feel that tired": exploring the complex bidirectional associations between maternal depressive symptoms and fatigue in a prospective pregnancy cohort study. Arch Womens Ment Health. 2016;19(1): 25-34. [Crossref]  [PubMed] 
  11. Vahdat M, Sariri E, Miri S, Rohani M, Kashanian M, Sabet A, et al. Prevalence and associated features of restless legs syndrome in a population of Iranian women during pregnancy. Int J Gynaecol Obstet. 2013;123(1):46-9. [Crossref]  [PubMed] 
  12. Minar M, Habanova H, Rusnak I, Planck K, Valkovic P. Prevalence and impact of restless legs syndrome in pregnancy. Neuro Endocrinol Lett. 2013;34(5):366-71. [PubMed] 
  13. Akbaş P, Yaman Sözbir Ş. Restless legs syndrome and quality of life in pregnant women. RAMB. 2019; 65(1): 618-24. [Crossref]  [PubMed] 
  14. Sönmez A. Huzursuz bacak sendromu olan gebelere verilen uyku hijyeni eğitiminin uyku kalitesine etkisi. [Erişim tarihi: 22 Temmuz 2021]. İnönü Üniversitesi Sağlık Bilimleri Enstitüsü, Ebelik Anabilim Dalı Yüksek Lisans Tezi, Malatya; 2017. p.23-33. Erişim linki: [Link] 
  15. Walters AS, LeBrocq C, Dhar A, Hening W, Rosen R, Allen RP, et al; International Restless Legs Syndrome Study Group. Validation of the International Restless Legs Syndrome Study Group rating scale for restless legs syndrome. Sleep Med. 2003;4(2):121-32. [Crossref]  [PubMed] 
  16. Yüksel B, Seven A, Yıldız Y, Kucur SK, Gözükara İ, Polat M, et al. Gebelikte huzursuz bacak sendromu [Restless leg syndrome in pregnancy]. The Journal of Gynecology-Obstetrics and Neonatology. 2015;12(4):144-6. [Link] 
  17. Çelik F, Köse M. Gebelikte uyku kalitesinin trimester ile ilişkisi [The relationship between sleep quality and trimester of pregnancy]. Kocatepe Tıp Dergisi. 2017;18(3):85-8. [Crossref] 
  18. Ağargün M, Kara H, Anlar O. Pittsburgh uyku kalitesi indeksinin geçerliği ve güvenirliği [The validity and reliability of the Pittsburgh sleep quality index]. Türk Psikiyatri Dergisi. 1996; 7(2):107-15. [Link] 
  19. Yurtsever S, Bedük T. Hemodiyaliz has talarında yorgunluğun değerlendirilmesi [Evaluation of fatigue on hemodialysis patients]. Hemşirelikte Araştırma Geliştirme Dergisi. 2003;5(2):3-12. [Link] 
  20. Kara B. Diyabetli hastalarda metabolik kontrol ile yorgunluk arasındaki ilişki [The relationship between metabolic control and fatigue in patients with diabetes]. Turkiye Klinikleri J Nurs. 2010;2(1):42-7. [Link] 
  21. Motosko CC, Bieber AK, Pomeranz MK, Stein JA, Martires KJ. Physiologic changes of pregnancy: A review of the literature. Int J Womens Dermatol. 2017;3(4):219-24. [Crossref]  [PubMed]  [PMC] 
  22. Terzi H, Terzi R, Zeybek B, Ergenoglu M, Hacivelioglu S, Akdemir A, et al. Restless legs syndrome is related to obstructive sleep apnea symptoms during pregnancy. Sleep Breath. 2015;19(1):73-8. [Crossref]  [PubMed] 
  23. Liu G, Li L, Zhang J, Xue R, Zhao X, Zhu K, et al. Restless legs syndrome and pregnancy or delivery complications in China: a representative survey. Sleep Med. 2016;17:158-62. [Crossref]  [PubMed] 
  24. Innes KE, Kandati S, Flack KL, Agarwal P, Selfe TK. The relationship of restless legs syndrome to history of pregnancy-induced hypertension. J Womens Health (Larchmt). 2016; 25(4):397-408. [Crossref]  [PubMed]  [PMC] 
  25. Almeneessie AS, Alyousefi N, Alzahrani M, Alsafi A, Alotaibi R, Olaish AH, et al. Prevalence of restless legs syndrome among pregnant women: A case-control study. Ann Thorac Med. 2020;15(1):9-14. [Crossref]  [PubMed]  [PMC] 
  26. Aktaş N, Karaçam Z. Doğum sonrası yorgunluk, kadının özbakım gücü ve ilişkili faktörler [Postpartum fatigue, self-care power of women and related factors]. Tepecik Eğit ve Araşt Hast Dergisi. 2017;27(3):186-96. [Link] 
  27. Bossuah KA. Fatigue in pregnancy. Int J Childbirth Educ. 2017;32(1):10-2.
  28. Grote NK, Bridge JA, Gavin AR, Melville JL, Iyengar S, Katon WJ. A meta-analysis of depression during pregnancy and the risk of preterm birth, low birth weight, and intrauterine growth restriction. Arch Gen Psychiatry. 2010;67(10):1012-24. [Crossref]  [PubMed]  [PMC] 
  29. Le Strat Y, Dubertret C, Le Foll B. Prevalence and correlates of major depressive episode in pregnant and postpartum women in the United States. J Affect Disord. 2011;135(1-3):128-38. [Crossref]  [PubMed] 
  30. Tamanna S, Geraci SA. Major sleep disorders among women: (women's health series). South Med J. 2013;106(8):470-8. [Crossref]  [PubMed] 
  31. Köybaşı EŞ, Oskay ÜY. Gebelik sürecinin uyku kalitesine etkisi [Effects of pregnancy process on the quality of sleep]. Gülhane Tıp Dergisi. 2017;59:1-5. [Crossref] 
  32. Okun ML, Schetter CD, Glynn LM. Poor sleep quality is associated with preterm birth. Sleep. 2011;34(11):1493-8. [Crossref]  [PubMed]  [PMC] 
  33. Sharma SK, Nehra A, Sinha S, Soneja M, Sunesh K, Sreenivas V, et al. Sleep disorders in pregnancy and their association with pregnancy outcomes: a prospective observational study. Sleep Breath. 2016;20(1):87-93. [Crossref]  [PubMed] 
  34. Zafarghandi N, Hadavand S, Davati A, Mohseni SM, Kimiaiimoghadam F, Torkestani F. The effects of sleep quality and duration in late pregnancy on labor and fetal outcome. J Matern Fetal Neonatal Med. 2012;25(5):535-7. [Crossref]  [PubMed] 
  35. Çoban A, Yanıkkerem UE. Gebelerde uyku kalitesi ve yorgunluk düzeyi [Sleep quality and fatigue in pregnant women]. Ege Journal of Medicine. 2010;49(2):87-94. [Link] 

.: Up To Date

Login



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