The Bahrain Medical Bulletin adheres to the principles and policies outlined below, which have been devised to ensure the accurate, clear, timely, fair and ethical publication of scientific papers. Such policies will benefit our authors, editors and readers as we strive for a trustworthy, transparent and efficient publishing process. The Bahrain Medical Bulletin is committed to maintaining the integrity of the published record and to publishing the most objective and unbiased scientific information. The Bulletin is a member of the Committee on Publication Ethics (COPE) and as such is committed to adhere to all established principles of ethical conduct in peer-reviewed publications. The policies below detail what we expect of the key participants in the publishing process: authors, reviewers and editors. These policies must be read in combination with, and as supplemented in, the information contained in four other sections the Bulletin notably:

  1. Mission and Scope
  2. Editorial and Publishing Policies
  3. Instructions to Authors
  4. Agreement/Disclosure Section

As such the information contained in the above four sections must be read as one unit. We also follow the criteria of the International Committee of Medical Journal Editors (http//:www.icmje.org), Standards for the Reporting of Diagnostic Accuracy Studies (STARD) (www.stard-statement.org), and Committee on Publication Ethics (http://publicationethics.org).


The Editors of the Bahrain Medical Bulletin will evaluate manuscripts for their intellectual content without regard to race, gender, sexual orientation, religious belief, ethnic origin, citizenship or political philosophy of the authors. Reviews should be conducted objectively. Personal criticism of the author is inappropriate. Reviewers should express their views clearly with supporting arguments.

Manuscript Submission and Management

All submissions are subjected to review by the Editors of the Bahrain Medical Bulletin and a panel of external peer reviewers in appropriate specialties. The receipt of all submissions will be acknowledged to the principal or corresponding author and once accepted these submissions including artwork shall remain the property of the Bahrain Medical Bulletin. Proofreading will also be carried out by the editors of the Bulletin. All submissions including advertisements must conform to standard codes of ethics. The acceptability of each article into the appropriate section of the Bahrain Medical Bulletin shall be decided by the Editors and referees of the Bulletin and this will be communicated to the authors before publication.

Authors must adhere to the style and format of the Bulletin and Instructions to Authors. Manuscripts that do not conform to these instructions are subject to rejection or delay. Papers submitted must be checked statistically and citation of references verified. Submission of manuscripts will be considered with the understanding that they have neither been published before nor under consideration (in any form or language) by any publishing media. Requests for duplicate publications will not be honored. An abstract published prior to submission of the full manuscript is not considered as a duplicate publication. Before initial submission of manuscripts, authors must consider authorship criteria, names and sequence of authors since amendments are not permitted. All authors whose name appears on a manuscript share equal responsibility as to the contents including the conduct of the research study and approval of the final manuscript. In accordance with international standard, the Editors may request the raw data or quality assurance assessment of any article under consideration. Manuscripts will be considered with the understanding that all the authors will accept editorial amendments before the article is sent to the press.

Editorial Management

Manuscripts are first assessed by the Chief Editor and Associate Editors and at this level the papers can be rejected without external peer review because of scientific unreliability, ethical consideration, design flaws, or inconsistency with Mission and Scope of the Bulletin. Subsequently, the manuscripts are discussed amongst the entire Editorial Board members and then sent to a minimum of two external peer reviewers. All comments from the peer-reviewers will be communicated to the corresponding authors along with Editorial Board comments/decision as to rejection, acceptance, or recommendation for acceptance with minor or major changes to be undertaken. The latter must be completed and returned to the Editorial Office within two weeks. Resubmissions are subject to further peer-review examination and further editorial decision if changes are not adequately answered to the best satisfaction of the Editorial Board. The Editors reserve the right to discuss the changes with the corresponding author only. Galley proofs will not be sent to authors for reading since manuscripts will be considered with the understanding that all the authors will accept editorial amendments before the article is sent to the press.

The Peer-Review Process and Right of Appeal

Authors’ identities will be masked from peer reviewers and their feedback will be anonymous unless they explicitly choose otherwise. The evaluation and comments of the reviewers will be discussed in the Editorial Board and accordingly the paper will be rendered an initial disposition of rejection, acceptance, or eligibility for consideration provided that minor or major revisions are undertaken by the authors. The comments of the reviewer and remarks from the Editors of the Bahrain Medical Bulletin will be conveyed to the corresponding author to undertake the editorial decision. All corrected and amended versions of the papers must be resubmitted within two weekdays. Failing that, the Editorial Board will consider the paper withdrawn from publication. Authors have the right to appeal the editorial decisions and this should be sent to the Editor within two weeks of the initial recommendation of the Editorial Board and must be concise and supported with valid and scientific arguments to substantiate the request. The Editor may reject the appeal or agree to further review the paper noting that an additional processing fee may apply. Authors are advised that appeal decisions are final.

Peer reviewers are asked to carry out in-depth objective analysis of critical thinking and criticism of the work before them and consider five principal criteria while assessing the suitability of a manuscript for publication namely: (1) Relevance to Mission and Scope of the Bahrain Medical Bulletin (2) Internal Validity of the study design and conduct; sound methodology, appropriate and applied use of statistics; and critical analysis, bias, reproducibility, and logical and scientific interpretation of results and validity of conclusions (3) External Validity including detailed description of the of study sample and its appropriateness for the results generated and use of relevant references (4) Level of Evidence as to the fulfillment of the aims of the study and whether the study will improve knowledge base beyond what is published on the topic (5) Ethical Conduct as to the originality of the study, approval of relevant institutional review boards, conflict of interest, bias, possible plagiarism, violation of research ethics, human or animal rights. For further steps on manuscript critical analysis, the reviewers can refer to: Rosenfeld RM. How to Review Journal Manuscripts. Otolaryngol Head Neck Surg 2010; 42:472-86.


Authorship credit should be based on criteria established by the International Committee of Medical Journal Editors: (1) substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data; (2) drafting the article or revising it critically for important intellectual content; and (3) final approval of the version to be published. Authors Must Meet Conditions 1, 2, and 3. Participation solely in the acquisition of funding or the collection of data does not justify authorship. General supervision of the research group is not sufficient for authorship.  Being the pathologist or radiologist who participated in diagnosing the case does not justify authorship, unless 1, 2, and 3 are met.  Otherwise, authors must submit written approval from these specialists if detailed description/analysis is used. Authors should be prepared to explain to the Editor the order in which authors are listed.

Competing (Conflicting) Interests

A competing or conflict of interest is anything that might inappropriately influence (bias), or might be perceived to interfere with, the full and objective presentation, review or publication of research findings or review-type material. Competing interests can be financial, professional or personal and can be held by authors, their employers, sponsors of the work, reviewers, editors and editorial staff. The Bahrain Medical Bulletin is committed to publishing the most objective and unbiased scientific information possible. As such, all participants in the publication process are required to disclose all relationships that could be viewed as potential competing interests. A conflict can be actual or potential, and full disclosure to The Editor is the safest course. Having a competing interest does not imply wrongdoing. Editors may choose to use competing interest statements as a basis for editorial decisions, but we do not reject papers simply because a conflict has been disclosed. However, failure to provide financial or competing interests disclosures in the original submission may delay its evaluation and review.

Author Competing Interests

A conflict of interest exists when an author or the author's institution has financial or personal relationships with other people or organizations that inappropriately influence (bias) his or her actions. Financial relationships are easily identifiable, but conflicts can also occur because of personal relationships, academic competition, professional association, or intellectual passion that could be perceived as interfering with the objectivity of their scientific judgement. Examples of financial conflicts include paid employment, consultancies, stock ownership, honoraria, paid expert testimony, patents or patent applications, travel grants, consultancy, board membership, gifts received, research grants, relationships with editors, membership in a lobbying organization, role as an expert witness, membership on a government advisory board, and relationships with organizations or funding groups. In such cases, authors should provide detailed information about current relationships extending beyond those listed on the title (address) page of their manuscript, as well as any anticipated for the foreseeable future. Authors should err on the side of disclosure in the event of uncertainty. Authors must include information regarding the provider of financial and material support of their research in the footnote of the Title page / and or the Materials and Methods section. This statement should include authors’ grant support, funding sources, and the provision of equipment and supplies. The disclosure statement should also be included in the covering letter submitted with the manuscript. Authors without financial or competing interests should explicitly assert this.

Reviewer Competing Interests

Unbiased independent critical assessment has a key place in scholarly publication. Reviewers should declare any association with authors of a paper. They should also disclose any financial or professional associations that could be perceived as interfering with the objectivity of their scientific assessment of a paper. If a reviewer feels they cannot referee a paper because of such a competing interest, they should inform the Editor that a potential conflict may exclude them. Author could request an exclusion of a reviewer with perceived competing interests from refereeing their paper; the request needs to be supported by additional information. The Editors will respect the request provided that they do not interfere with the objective and thorough assessment of an article.

Editor and Editorial Staff Competing Interests

Editors who make final editorial decisions on articles must have no financial, personal, professional or commercial involvement with the manuscript under consideration. If a potential bias exists, they should withdraw from handling the article. Editors are asked to disclose their potential competing interests, and editorial staff members are not permitted to use information gained through working with manuscripts for private gain.

Confidentiality of Manuscripts

Editors and reviewers are expected to treat articles confidentially. They must not disclose information about manuscripts (including their receipt, content, status in the publishing process, reviewer feedback and final decision) to anyone, other than the Chief Editor. They should not use knowledge of the work before its publication to further their own interests. Reviewers also have the right to confidentiality; they will remain anonymous and their comments will not be published. In situations where a reviewer wishes to co-review an article with another peer, they must first seek the permission of the Editor, and their colleague must abide by the same rules of confidentiality.

Research Integrity

Research misconduct is defined as follows: fabrication, falsification, or plagiarism in proposing, performing, or reviewing research, or in reporting research results. Should a suspicion or allegation of scientific misconduct or fraudulent research publication submitted be raised, the Editors of the Bahrain Medical Bulletin reserve the right to raise these concerns with the sponsoring or funding institution or other appropriate authority for investigation.

Integrity of the Scientific Record

The Editors and the Editorial Board must assume initially that articles submitted for consideration are honest reports. They will also take all necessary steps to maintain the accuracy and quality of the published papers. To this end, Bahrain Medical Bulletin will publish correspondence, errata and corrigenda when appropriate. However, in situations were errors and scientific misconduct are noted in published works it may be necessary to undertake other actions such as corrections, retractions or the publication of an expression of concern

The Following Actions May be Undertaken

(1) Inadequacies exposed by the emergence of new scientific information during the course of the research will not be retracted but addendum noted (2) Errors noted in parts of the published articles will be followed by erratum of the concerned part but those with serious error of the entire work will be vitiated after discussion with the authors (3) It is the responsibility of the Editor to question fraudulent submitted or published works but not to make full investigation to determine responsibilities, that lies with the institutions. Upon formal Institutional Review Board (IRB) decision, the Editor will decide on the acceptability of a submitted study, retraction of published work or the publication of expression of concern in a prominent section of the Bulletin (4) Papers published in the Bulletin and subsequently found to be plagiarized or duplicates will be dealt with in accordance with international ethical guidelines including those of COPE (http://publicationethics.org). In such cases, the article will be deleted from our database and a note of retraction will be published in a prominent section of the Bulletin. Furthermore, the indexing services and the primary publisher will be notified and copies of all correspondences sent to the institutions of all authors.

Publication Policies

All versions of published articles will remain available once published. Preservation of electronic versions of articles in a permanent archive is an essential component of today’s publishing. The Bahrain Medical Bulletin shall maintain this permanence and shall adopt the DOI (Digital Object Identifier) system to enable accurate citation and stable online availability of published articles.

Ethical Consent, Institutional Review Board (IRB) and Animal Studies

All submissions must contain a reference / statement of approval from an Institutional Review Board (IRB). An IRB or similar authorities means a certified, official and recognized body directly responsible for the final approval and conduct of the research study (including the use of clinical databases, scientific data, patient information, databases, experimental studies) and its publication; it is the body which approves the use of institutional data. Approval from IRB or similar authorities may include that of research / ethical committees, and animal experimentation committees.

Manuscripts reporting on data involving human participation must be accompanied by copies of the formal approval or formal waiver (exemption) from a recognized and appropriate IRB and ethical committee (or similar organizations) and should be described in the Materials and Methods section with full name and contact details of the reviewing entity. All clinical research requires formal review approval, including case reports, medical records reviews and other observational studies. Original research studies should have IRB approval and randomized controlled studies must be registered. All manuscripts reporting results involving human experimentation should include explicit statements that informed written consent was obtained from these subjects or their guardians after receiving written approval or formal waiver (exemption) from recognized local research and ethical authorities or similar IRB. This is also to ensure authorisation and to avoid duplicate reporting from the same institution. For animal experiments, submit copies of formal relevant approval from concerned authorities and state animal-handling protocol including approval in the Materials and Methods section of the manuscript. Manuscripts containing photographs of a person must be accompanied by legal written release from the person. Covering the eyes is not adequate to conceal the identity.