Journal of Literature Pharmacy Sciences

Lipid Metabolizmasını Düzenleyici Etkileri Nedeniyle Kullanılan Farklı Bitkilerin Olası Toksik Etkileri: Sistematik Derleme
Possible Toxic Effects of Different Plants Due to Its Regulatory Effects on Lipid Metabolism: Systematic Review
İlknur Sıla LEBLEBİCİa, Jülide SECERLİa, Merve BACANLIa, Onur ERDEMa
aSağlık Bilimleri Üniversitesi Gülhane Eczacılık Fakültesi, Farmasötik Toksikoloji ABD, Ankara, TÜRKİYE
J Lit Pharm Sci. 2021;10(3):332-42
doi: 10.5336/pharmsci.2020-79097
Article Language: TR
Full Text
ÖZET
Bitkiler, çeşitli zengin biyoaktif bileşenleri sayesinde birçok hastalığın önlenmesi ve tedavisi için binlerce yıldır kullanılmakta olup, günümüzde de dünya çapında nüfusun büyük çoğunluğu için en önemli doğal sağlık kaynağıdır. Tıbbi bitkilerin hiperlipidemi, diyabet ve kardiyovasküler hastalıklar gibi farklı hastalıkları tedavi etmek için kullanımı son yıllarda popülerlik kazanmıştır. Hiperlipidemi, yaygın görülen bir hastalık olup, dünya çapında önemli bir morbidite ve mortalite nedeni olan kardiyovasküler hastalıklar için mühim bir risk faktörüdür. Hiperlipidemi tedavisinde 1. basamakta tercih edilen statin grubu ilaçlar; kas ağrısı, güçsüzlük ve depresyon insidansında artışla ilişkilendirilir. Mevcut lipid düşürücü ilaçların istenmeyen etkilerinin fazlalığı, geleneksel ve alternatif tedavilere yönelme eğilimini artırmıştır. Son zamanlarda yapılan çalışmalarda, antihiperlipidemik özelliklere sahip tıbbi bitkilerin varlığı gösterilmiştir. Çeşitli bitki türleri, içeriğindeki vitaminler, flavonoidler, steroller ve antioksidanlar dâhil olmak üzere pek çok bileşik sayesinde farklı yollarla serum lipid profilini potansiyel olarak azaltabilir. Tıbbi bitkilerin, lipid düşürücü etki mekanizmaları net olmamakla birlikte enterositlerde kolesterol emiliminin engellenmesi, endojen lipidlerin biyosentezinin azaltılması, karaciğerde kolesterol atılımının teşvik edilmesi ve lipid metabolizmasıyla ilgili transkripsiyon faktörlerinin düzenlenmesi en muhtemel mekanizmalar olarak görülmektedir. Bununla birlikte bitkisel ürünlerin kullanımı tamamen güvenli değildir ve organ toksisitesi, alerjik reaksiyonlar ve bitki-ilaç etkileşimleri dâhil çeşitli istenmeyen etkilere neden olabilir. Bu derleme kapsamında, lipid metabolizması üzerine düzenleyici etkileri olduğu iddia edilen farklı bitkiler, bu bitkilerin etkileri ve olası toksik etkilerinin değerlendirilmesi amaçlanmıştır.

Anahtar Kelimeler: Lipid metabolizması; istenmeyen etki; bitkisel
ABSTRACT
Plants are being used for thousands of years for the prevention and treatment of many diseases, and are still the most important natural health resource for the vast majority of the population worldwide. The use of medicinal plants to treat different diseases such as hyperlipidemia, diabetes and cardiovascular diseases has gained popularity in recent years. Hyperlipidemia is a common disease and an important risk factor for cardiovascular diseases, an important cause of morbidity and mortality worldwide. Statin group drugs, which are preferred as first-line therapy for hyperlipidemia are associated with an increased incidence of muscle pain, weakness, and depression. The adverse effects of existing lipid-lowering drugs have increased the trend towards traditional and alternative therapies. Recently, a growing number of studies have demonstrated the presence of medicinal plants with antihyperlipidemic properties. Various plant species can potentially reduce the serum lipid profile in different ways, due to many compounds, including vitamins, flavonoids, sterols, and antioxidants. Although the lipid-lowering effect mechanisms of medicinal plants are unclear, the most likely mechanisms are inhibition of cholesterol absorption in enterocytes, reduction of biosynthesis of endogenous lipids, promotion of cholesterol excretion in the liver, and regulation of lipid metabolism transcription factors. However, the use of herbal products is not completely safe and can cause a variety of adverse effects, including organ toxicity, allergic reactions, and herb-drug interactions. In this review, it is aimed to evaluate different plants that claim to have regulatory effects on lipid metabolism, their effects and possible toxic effects.

Keywords: Lipid metabolism; adverse effect; herbal
REFERENCES:
  1. Morales-González JA, Madrigal-Bujaidar E, Sánchez-Gutiérrez M, Izquierdo-Vega JA, Valadez-Vega MDC, Álvarez-González I, et al. Garlic (Allium sativum L.): a brief review of its antigenotoxic effects. Foods. 2019;8(8):343. [Crossref] [PubMed] [PMC] 
  2. Gardner CD, Messina M, Lawson LD, Farquhar JW. Soy, garlic, and ginkgo biloba: their potential role in cardiovascular disease prevention and treatment. Curr Atheroscler Rep. 2003;5(6):468-75. [Crossref] [PubMed] 
  3. Handral HK, Pandith A, Sd S. A review on Murraya koenigii: multipotential medicinal plant. Asian J Pharm Clin Res. 2012;5(4):5-14. [Link] 
  4. Hajimonfarednejad M, Ostovar M, Raee MJ, Hashempur MH, Mayer JG, Heydari M. Cinnamon: a systematic review of adverse events. Clin Nutr. 2019;38(2):594-602. [Crossref] [PubMed] 
  5. Izzo AA, Hoon-Kim S, Radhakrishnan R, Williamson EM. A critical approach to evaluating clinical efficacy, adverse events and drug interactions of herbal remedies. Phytother Res. 2016;30(5):691-700. [Crossref] [PubMed] 
  6. Yang YS, Su YF, Yang HW, Lee YH, Chou JI, Ueng KC. Lipid-lowering effects of curcumin in patients with metabolic syndrome: a randomized, double-blind, placebo-controlled trial. Phytother Res. 2014;28(12):1770-7. [Crossref] [PubMed] 
  7. Ried K, Toben C, Fakler P. Effect of garlic on serum lipids: an updated meta-analysis. Nutr Rev. 2013;71(5):282-99. [Crossref] [PubMed] 
  8. Yadav SP, Vats V, Ammini AC, Grover JK. Brassica juncea (Rai) significantly prevented the development of insulin resistance in rats fed fructose-enriched diet. J Ethnopharmacol. 2004;93(1):113-6. [Crossref] [PubMed] 
  9. Joshi SC, Sharma N, Sharma P. Antioxidant and lipid lowering effects of Coriandrum sativum in cholesterol fed rabbits. Int J Pharm Pharm Sci. 2012;4(3):231-4. [Link] 
  10. Asgarpanah J, Mohajerani R. Phytochemistry and pharmacologic properties of Urtica dioica L. Journal of Medicinal Plants Research. 2012;6(46):5714-9. [Link] 
  11. Joshi BC, Mukhija M, Kalia AN. Pharmacognostical review of Urtica dioica L. Int J Green Pharm. 2014;8(4):201-9. [Crossref] 
  12. Upton R. Stinging nettles leaf (Urtica dioica L.): Extraordinary vegetable medicine. J Herb Med. 2013;3(1):9-38. [Crossref] 
  13. Daher CF, Baroody KG, Baroody GM. Effect of Urtica dioica extract intake upon blood lipid profile in the rats. Fitoterapia. 2006;77(3):183-8. [Crossref] [PubMed] 
  14. Nassiri-Asl M, Zamansoltani F, Abbasi E, Daneshi MM, Zangivand AA. Effects of Urtica dioica extract on lipid profile in hypercholesterolemic rats. Chin J Integr Med. 2009;7(5):428-33. [PubMed] 
  15. Esposito S, Bianco A, Russo R, Di Maro A, Isernia C, Pedone PV. Therapeutic perspectives of molecules from Urtica dioica extracts for cancer treatment. Molecules. 2019;24(15): 2753. [Crossref] [PubMed] [PMC] 
  16. Uslu S, Bulbul A, Diler B, Bas EK, Nuhoglu A. Urticaria due to Urtica dioica in a neonate. Eur J Pediatr. 2011;170(3):401-3. [Crossref] [PubMed] 
  17. Chrubasik JE, Roufogalis BD, Wagner H, Chrubasik S. A comprehensive review on the stinging nettle effect and efficacy profiles. Part II: urticae radix. Phytomedicine. 2007;14(7-8):568-79. [Crossref] [PubMed] 
  18. Paoletti A, Gallo E, Benemei S, Vietri M, Lapi F, Volpi R, et al. Interactions between natural health products and oral anticoagulants: spontaneous reports in the Italian Surveillance System of Natural Health Products. Evid Based Complement Alternat Med. 2011;2011:612 150. [Crossref] [PubMed] [PMC] 
  19. Arslanoglu SF, Aytac S. The important of flax (Linum usitatissimum L.) in terms of health. Int J Life Sci Biotecnology. 2020;3(1):95-107. [Link] 
  20. Khalesi S, Jamaluddin R, Ismail A. Effect of raw and heated flaxseed (Linum usitatissimum L.) on blood lipid profiles in rats. Int J Appl Sci Technol. 2011;1(4):84-9. [Link] 
  21. Lucas EA, Lightfoot SA, Hammond LJ, Devareddy L, Khalil DA, Daggy BP, et al. Flaxseed reduces plasma cholesterol and atherosclerotic lesion formation in ovariectomized Golden Syrian hamsters. Atherosclerosis. 2004;173(2):223-9. [Crossref] [PubMed] 
  22. Pan A, Yu D, Demark-Wahnefried W, Franco OH, Lin X. Meta-analysis of the effects of flaxseed interventions on blood lipids. Am J Clin Nutr. 2009;90(2):288-97. [Crossref] [PubMed] [PMC] 
  23. Verma R, Prasad R, Gupta A. Functional properties and health benefits in flaxseed fiber and oil (Linum usitatissimum L.). Int J Home Sci. 2017;3(1):368-9. [Link] 
  24. ESCOP [İnternet]. Copyright © 1999-2020 ESCOP [Erişim tarihi: 30.1.2021]. Table of herb-drug interactions based on the monographs of ESCOP. Erişim linki: [Link] 
  25. Community Herbal Monograph on Linum usitatissimum L., Semen. London: 2006. Doc. Ref: EMEA/HMPC/340849/2005. Erişim tarihi: 30.1.2021. Erişim linki: [Link] 
  26. Cardoso Carraro JC, de Souza Dantas MI, Espeschit ACR, Martino HSD, Ribeiro SMR. Flaxseed and human health: reviewing benefits and adverse effects. Food Rev Int. 2012;28(2):203-30. [Crossref] 
  27. Coşkuner Y, Karababa E. Physical properties of coriander seeds (Coriandrum sativum L.). Journal of Food Engineering. 2007;80(2):408-16. [Crossref] 
  28. Mandal S, Mandal M. Coriander (Coriandrum sativum L.) essential oil: Chemistry and biological activity. Asian Pac J Trop Biomed. 2015;5(6):421-8. [Crossref] 
  29. Chithra V, Leelamma S. Hypolipidemic effect of coriander seeds (Coriandrum sativum): mechanism of action. Plant Foods Hum Nutr. 1997;51(2):167-72. [Crossref] [PubMed] 
  30. Burdock GA, Carabin IG. Safety assessment of coriander (Coriandrum sativum L.) essential oil as a food ingredient. Food Chem Toxicol. 2009;47(1):22-34. [Crossref] [PubMed] 
  31. Asgarpanah J, Kazemivash N. Phytochemistry, pharmacology and medicinal properties of Coriandrum sativum L. Afr J Pharm Pharmacol. 2012;6(31): 2340-5. [Crossref] 
  32. Heibatullah K, Marzieh P, Arefeh I, Ebrahim M. Genotoxicity determinations of coriander drop and extract of Coriander sativum cultured fibroblast of rat embryo by comet assay. Saudi Pharm J. 2008;16(1):85-8. [Link] 
  33. Mahmoud I, Alkofahi A, Abdelaziz A. Mutagenic and toxic activities of several spices and some Jordanian medicinal plants. Pharm Biol. 1992; 30(2):81-5. [Crossref] 
  34. Peter EL, Deyno S, Mtewa A, Kasali FM, Nagendrappa PB, Sesaazi D, et al. Safety and efficacy of Momordica charantia Linnaeus in pre-diabetes and type 2 diabetes mellitus patients: a systematic review and meta-analysis protocol. Syst Rev. 2018;192. [Crossref]  [PubMed]  [PMC] 
  35. Khan MF, Abutaha N, Nasr FA, Alqahtani AS, Noman OM, Wadaan MAM. Bitter gourd (Momordica charantia) possess developmental toxicity as revealed by screening the seeds and fruit extracts in zebrafish embryos. BMC Complement Altern Med. 2019;19(1):184. [Crossref] [PubMed] [PMC] 
  36. Wang S, Li Z, Yang G, Ho CT, Li S. Momordica charantia: a popular health-promoting vegetable with multifunctionality. Food Funct. 2017;8(5):1749-62. [Crossref] [PubMed] 
  37. Jia S, Shen M, Zhang F, Xie J. Recent advances in Momordica charantia: functional components and biological activities. Int J Mol Sci. 2017;18(12):2555. [Crossref] [PubMed] [PMC] 
  38. Grover JK, Yadav SP. Pharmacological actions and potential uses of Momordica charantia: a review. J Ethnopharmacol. 2004; 93(1):123-32. [Crossref] [PubMed] 
  39. Raman A, Lau C. Anti-diabetic properties and phytochemistry of Momordica charantia L. (Cucurbitaceae). Phytomedicine. 1996;2(4): 349-62. [Crossref] [PubMed] 
  40. Leung L, Birtwhistle R, Kotecha J, Hannah S, Cuthbertson S. Anti-diabetic and hypoglycaemic effects of Momordica charantia (bitter melon): a mini review. Br J Nutr. 2009;102(12): 1703-8. [Crossref] [PubMed] 
  41. Temitope AG, Lekan OS. Effect of Momordica charantia (Bitter Melon) leaves on haemoglobin concentration in male albino rats. Int Blood Res Rev. 2014;2(2):82-6. [Crossref] 
  42. Bortolotti M, Mercatelli D, Polito L. Momordica charantia, a nutraceutical approach for inflammatory related diseases. Front Pharmacol. 2019;10:486. [Crossref] [PubMed] [PMC] 
  43. Singh VK, Singh DK. Pharmacological effects of garlic (Allium sativum L.). Annu Rev Biomed Sci. 2008;10:6-26. [Crossref] 
  44. Borrelli F, Capasso R, Izzo AA. Garlic (Allium sativum L.): adverse effects and drug interactions in humans. Mol Nutr Food Res. 2007;51(11):1386-97. [Crossref] [PubMed] 
  45. Block E. The organosulfur chemistry of the genus Allium-implications for the organic chemistry of sulfur. Angew Chem Int Ed Engl. 1992;31(9): 1135-78. [Crossref] 
  46. Gebhardt R. Multiple inhibitory effects of garlic extracts on cholesterol biosynthesis in hepatocytes. Lipids. 1993;28(7):613-9. [Crossref]  [PubMed] 
  47. Kojuri J, Vosoughi AR, Akrami M. Effects of anethum graveolens and garlic on lipid profile in hyperlipidemic patients. Lipids Health Dis. 2007;6:5. [Crossref] [PubMed] [PMC] 
  48. Parish RA, McIntire S, Heimbach DM. Garlic burns: a naturopathic remedy gone awry. Pediatr Emerg Care. 1987;3(4):258-60. [Crossref]  [PubMed] 
  49. Jappe U, Bonnekoh B, Hausen BM, Gollnick H. Garlic-related dermatoses: case report and review of the literature. Am J Contact Dermat. 1999;10(1):37-9. [Crossref] [PubMed] 
  50. Dausch JG, Nixon DW. Garlic: a review of its relationship to malignant disease. Prev Med. 1990;19(3):346-61. [Crossref] [PubMed] 
  51. Jani A, Mehta A. Pharmacology of Allium sativum in relation to Cytochrome P450 and possible drug interactions. Pharmacogn Rev. 2007;1(2):222-6. [Link] 
  52. Hammami I, El May MV. Impact of garlic feeding (Allium sativum) on male fertility. Andrologia. 2013;45(4):217-24. [Crossref] [PubMed] 
  53. Dugoua JJ, Seely D, Perri D, Cooley K, Forelli T, Mills E, et al. From type 2 diabetes to antioxidant activity: a systematic review of the safety and efficacy of common and cassia cinnamon bark. Can J Physiol Pharmacol. 2007;85(9):837-47. [Crossref] [PubMed] 
  54. Ranasinghe P, Jayawardena R, Pigera S, Wathurapatha WS, Weeratunga HD, Premakumara GAS, et al. Evaluation of pharmacodynamic properties and safety of Cinna momum zeylanicum (Ceylon cinnamon) in healthy adults: a phase I clinical trial. BMC Complement Altern Med. 2017;17(1):550. [Crossref] [PubMed] [PMC] 
  55. Rafehi H, Ververis K, Karagiannis TC. Controversies surrounding the clinical potential of cinnamon for the management of diabetes. Diabetes Obes Metab. 2012;14(6):493-9. [Crossref] [PubMed] 
  56. Oliveira Jde A, da Silva IC, Trindade LA, Lima EO, Carlo HL, Cavalcanti AL, et al. Safety and Tolerability of essential oil from Cinnamomum zeylanicum Blume leaves with action on oral candidosis and its effect on the physical properties of the acrylic resin. Evid Based Complement Alternat Med. 2014;2014:325670. [Crossref] [PubMed] [PMC] 
  57. Ranasinghe P, Perera S, Gunatilake M, Abeywardene E, Gunapala N, Premakumara S, et al. Effects of Cinnamomum zeylanicum (Ceylon cinnamon) on blood glucose and lipids in a diabetic and healthy rat model. Pharmacognosy Res. 2012;4(2):73-9. [PubMed] [PMC] 
  58. Maierean SM, Serban MC, Sahebkar A, Ursoniu S, Serban A, Penson P, et al; Lipid and Blood Pressure Meta-analysis Collaboration (LBPMC) Group. The effects of cinnamon supplementation on blood lipid concentrations: A systematic review and meta-analysis. J Clin Lipidol. 2017;11(6):1393-406. [Crossref]  [PubMed] 
  59. Akilen R, Tsiami A, Robinson N. Efficacy and safety of 'true' cinnamon (Cinnamomum zeylanicum) as a pharmaceutical agent in diabetes: a systematic review and meta-analysis. Diabet Med. 2013;30(4):505-6. [Crossref] [PubMed] 
  60. De Benito V, Alzaga R. Occupational allergic contact dermatitis from cassia (Chinese cinnamon) as a flavouring agent in coffee. Contact Derm. 1999;40(3):165. [Crossref] [PubMed] 
  61. Isaac-Renton M, Li MK, Parsons LM. Cinnamon spice and everything not nice: many features of intraoral allergy to cinnamic aldehyde. Dermatitis. 2015;26(3):116-21. [Crossref] [PubMed] 
  62. Nadiminti H, Ehrlich A, Udey MC. Oral erosions as a manifestation of allergic contact sensitivity to cinnamon mints. Contact Derm. 2005;52(1):46-7. [Crossref] [PubMed] 
  63. Hoskyn J, Guin JD. Contact allergy to cinnamal in a patient with oral lichen planus. Contact Derm. 2005;52(3):160-1. [Crossref]  [PubMed] 
  64. Mang B, Wolters M, Schmitt B, Kelb K, Lichtinghagen R, Stichtenoth DO, et al. Effects of a cinnamon extract on plasma glucose, HbA, and serum lipids in diabetes mellitus type 2. Eur J Clin Invest. 2006;36(5):340-4. [Crossref] [PubMed] 
  65. Patil BS, Jayaprakasha GK, Chidambara Murthy KN, Vikram A. Bioactive compounds: historical perspectives, opportunities, and challenges. J Agric Food Chem. 2009;57(18): 8142-60. [Crossref] [PubMed] 
  66. Kocaadam B, Şanlier N. Curcumin, an active component of turmeric (Curcuma longa), and its effects on health. Crit Rev Food Sci Nutr. 2017;57(13):2889-95. [Crossref] [PubMed] 
  67. Zhang W, Liu D, Wo X, Zhang Y, Jin M, Ding Z. Effects of Curcuma Longa on proliferation of cultured bovine smooth muscle cells and on expression of low density lipoprotein receptor in cells. Chin Med J (Engl). 1999;112(4):308-11. [PubMed] 
  68. Neerati P, Devde R, Gangi AK. Evaluation of the effect of curcumin capsules on glyburide therapy in patients with type-2 diabetes mellitus. Phytother Res. 2014;28(12):1796-800. [Crossref] [PubMed] 
  69. Chainani-Wu N. Safety and anti-inflammatory activity of curcumin: a component of tumeric (Curcuma longa). J Altern Complement Med. 2003;9(1):161-8. [Crossref] [PubMed] 
  70. Nagpal M, Sood S. Role of curcumin in systemic and oral health: An overview. J Nat Sci Biol Med. 2013;4(1):3-7. [Crossref] [PubMed] [PMC] 
  71. Vaughn AR, Branum A, Sivamani RK. Effects of turmeric (Curcuma longa) on skin health: a systematic review of the clinical evidence. Phytother Res. 2016;30(8):1243-64. [Crossref] [PubMed] 
  72. Calapai G, Miroddi M, Minciullo PL, Caputi AP, Gangemi S, Schmidt RJ. Contact dermatitis as an adverse reaction to some topically used European herbal medicinal products - part 1: Achillea millefolium-Curcuma longa. Contact Derm. 2014;71(1):1-12. [Crossref] [PubMed] 
  73. Gupta SC, Kismali G, Aggarwal BB. Curcumin, a component of turmeric: from farm to pharmacy. Biofactors. 2013;39(1):2-13. [Crossref] [PubMed] 
  74. Jiao Y, Wilkinson J 4th, Di X, Wang W, Hatcher H, Kock ND, et al. Curcumin, a cancer chemopreventive and chemotherapeutic agent, is a biologically active iron chelator. Blood. 2009;113(2):462-9. [Crossref] [PubMed] [PMC] 
  75. Devassy JG, Nwachukwu ID, Jones PJ. Curcumin and cancer: barriers to obtaining a health claim. Nutr Rev. 2015;73(3):155-65. [Crossref]  [PubMed] 

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