The initial manuscript evaluation is done by the editor. Manuscript is not accepted at this stage. The manuscript is then reviewed by a member of the editorial team in detail or the editor, in terms of the initial assessment, which comprises of pre-requisites such as an ethical review letter by the IRB, conflict of interest statement, certificate of authors with their complete name, email addresses, contribution according to the ICMJE guidelines, word count appropriate for the article submitted, references in Vancouver style and their number according to the type of article. Also, checked for the grammar, abstract; structured or unstructured, key words according to MeSH, pages numbered, tables self-explanatory and details of the introduction, methodology (especially study design), statistics, results, discussion and conclusion.

Those articles that meet the minimum criteria are sent to 2 peer reviewers, which is double-blind, where both the author and referee remain anonymous throughout the process. The referees are selected according to their expertise and we try to maintain a database of referees which is continuously updated. After the peer review form is completed the peer reviewer gives a summarised paragraph of the articles originality, importance, presentation, significance of results, inference, impact of research in the relevant field and ethical aspects. If rejected, adds a paragraph mentioning the reasons for rejection. Comments for the editor are added and summarised comments are mandatory with a separate paragraph. A separate form is present for peer review for a case report and a separate one for the original article/short communication/short report, etc. the time given to peer reviewers is maximum 3 weeks and the reviewer is requested to inform the editor at an early stage if they cannot review the article.

If both reviewers reject the article, then the article is generally rejected with the reasons being sent to the author. However,the final decision and responsibility rests with the editor, whether to accept or reject the article.