- ISSN
- 2960-1959
- Founded
- 2023
- Frequency
- Biannual
- Publisher
- Barw
An open-access, peer-reviewed medical journal publishing clinical and basic science, with a particular commitment to research from low- and middle-income countries.
Barw Medical Journal focuses especially on the research output from developing countries and encourages authors from these regions of the world to contribute actively and effectively to the construction of medical literature.
- Access
- Open access
- Free to read, no subscription
- To first decision
- 7–21 days
- Typical first review round
- Peer review
- Double-blind
- Authors and reviewers both blinded
- Licence
- CC BY 4.0
- Authors keep copyright
Call for papers
Volume 4, Issue 2 is open for submissions.
Original articles, systematic reviews, meta-analyses, case reports and correspondence across the medical disciplines. Double-blind review, with a first decision typically inside 7 to 21 days.
Latest issue
Latest articles
-
Resistance Patterns of Gram-Negative Bacteria and Surgical Site Infections Across the Middle East: A Systematic Review and Meta-Analysis
Early View Articles
Resistance Patterns of Gram-Negative Bacteria and Surgical Site Infections Across the Middle East: A Systematic Review and Meta-Analysis
IntroductionSurgical site infections (SSIs) are a leading healthcare-associated infection, driven by multidrug-resistant Gram-negative bacteria. Regional data from the Middle East remain limited. This meta-analysis aimed to estimate pooled antimicrobial resistance (AMR) profiles of Gram-negative isolates (GNI) recovered from SSIs.
MethodsPubMed/MEDLINE and Google Scholar were searched in January 2026 for studies reporting AMR in SSI GNI. Eligible studies were English-language reports from the Middle East presenting AMR patterns of Gram-negative bacteria recovered from SSIs. Case reports, laboratory and animal studies, conference papers, and abstract-only publications were ineligible. Proportions were pooled using DerSimonian-Laird random-effects models with Freeman-Tukey double-arcsine transformation, heterogeneity assessed by I².
ResultsTwenty-three studies from 8 countries were included. GNI comprised 71.9% (95% CI 60.5-82.2) of all culture-positive isolates and, when restricted to SSI-confirmed specimens, 86.4% (95% CI 63.6-99.3). Escherichia coli was most frequent (27.9%), followed by Pseudomonas aeruginosa (25.8%) and Klebsiella pneumoniae (21.3%). Resistance exceeded 65% for ampicillin in E. coli and for ceftriaxone in both E. coli and K. pneumoniae, with resistance to the remaining third-generation cephalosporins (cefotaxime, ceftazidime) ranging from 46.5% to 85.9%.
ConclusionGram-negative SSI isolates in the Middle East showed high resistance across many agent classes, with substantial multidrug resistance, carbapenem resistance, and ESBL production. This regional resistance profile reinforces the need for local, SSI-specific surveillance and antimicrobial stewardship.
Keywords Surgical site infection Antimicrobial resistance Gram-negative bacteria Multidrug resistance Middle East All subjects
Barw Medical Journal. 2026;4(4)
-
Factors Affecting the Adoption of Metaverse Technology Among Librarians in Federal Universities of Technology in Nigeria
Original Articles
Factors Affecting the Adoption of Metaverse Technology Among Librarians in Federal Universities of Technology in Nigeria
IntroductionLibrarians' readiness for metaverse technology in Nigerian universities of technology is not well documented. This study aimed to assess librarians' awareness, digital skills, perceived infrastructure, organizational support, and challenges regarding metaverse technology in Federal Universities of Technology in Nigeria, and to examine the relationships between awareness and digital skills and between infrastructure and organizational support.
MethodsThis cross-sectional survey was conducted between April and July 2026 in six Federal Universities of Technology in Nigeria. Academic librarians in these universities who agreed to participate were included, and incomplete questionnaires were excluded. Data were collected with a validated online questionnaire using four-point scales. Descriptive statistics were used with a criterion mean of 2.50, and Pearson correlation was used to test the hypotheses at a 0.05 significance level.
ResultsA total of 103 librarians were included. Overall, 97 (94.2%) reported very high or high awareness of the metaverse concept. While 91 (88.3%) reported being able to operate metaverse access devices, 29 (28.2%) reported being able to upload library content. Reliable internet connectivity was reported by 87 (84.5%), and augmented reality devices by 27 (26.2%). Inadequate training was the most highly rated challenge, reported by 98 (95.1%). Awareness was correlated with digital skills (r = 0.49, p < 0.001), and infrastructure with organizational support (r = 0.38, p < 0.001).
ConclusionLibrarians appeared to be aware of metaverse technology, but their skills and resources seemed better suited to accessing virtual environments than to delivering library services within them.
Keywords Metaverse technology Digital skills Technological infrastructure Organisational support Academic librarians All subjects
Barw Medical Journal. 2026;4(4):1–11
-
Safety and Efficacy of Atezolizumab in Ovarian Cancer
Early View Articles
Safety and Efficacy of Atezolizumab in Ovarian Cancer
IntroductionAlthough the efficacy of PD-L1 blockade has been evaluated in analyses that combine pharmacologically distinct antibodies, the specific efficacy and safety of atezolizumab remain unclear. This review aimed to evaluate the efficacy and safety profile of atezolizumab specifically.
MethodsPubMed/MEDLINE and CENTRAL were searched (June 2026) for phase I to III trials of atezolizumab in ovarian cancer, reported in full-text English with at least 10 evaluable patients. Randomized and single-arm designs qualified. Randomized comparisons were pooled under random-effects models with Knapp-Hartung adjustment as hazard ratios for survival and risk ratios for response and safety; single-arm rates were pooled as proportions using generalized linear mixed models. Heterogeneity was assessed with I², Cochran Q, and prediction intervals, with leave-one-out sensitivity analysis. Analyses used R 4.6.0.
ResultsTwelve studies (13 reports) enrolled 3,179 patients. Atezolizumab reduced the hazard of progression (HR 0.88, 95% CI 0.83 to 0.93) and death (HR 0.86, 95% CI 0.78 to 0.96), without heterogeneity (I² = 0%), whereas objective response was unchanged (RR 0.88, 95% CI 0.52 to 1.49). Excess toxicity was immune-mediated, raising serious adverse events (RR 1.32, 95% CI 1.05 to 1.67), any-grade immune-related events (RR 1.57, 95% CI 1.12 to 2.20), and grade ≥3 immune-related events (RR 2.23, 95% CI 1.05 to 4.74).
ConclusionAtezolizumab adds a small survival benefit to a chemotherapy or bevacizumab backbone, driven by delayed progression rather than tumor regression. Offset by doubled immune toxicity and inseparable from its backbone, the effect may not justify routine use.
Keywords Atezolizumab Ovarian neoplasms Immune checkpoint inhibitors Immune-related adverse events Progression-free survival Meta-analysis All subjects
Barw Medical Journal. 2026;4(4)
-
Torsades de Pointes Following Ondansetron Administration: A Case Report with literature review
Case Reports
Torsades de Pointes Following Ondansetron Administration: A Case Report with literature review
IntroductionOndansetron blocks human ether-à-go-go-related gene (hERG) potassium channels, causing QT prolongation and risk of torsades de pointes (TdP). Despite its widespread use, TdP following a standard intravenous dose is rarely reported. This report presents a case of a 40-year-old female who developed TdP after receiving an 8 mg intravenous dose of ondansetron.
Case PresentationA 40-year-old female with no significant past medical history presented with vomiting and diarrhea. Approximately 30 minutes after receiving 8 mg of intravenous ondansetron, she developed TdP requiring cardioversion. Laboratory results revealed mild hypokalemia (3.12 mmol/L). Post-event troponin elevation and Grade I diastolic dysfunction suggested transient myocardial involvement. She was stabilized with potassium replacement and supportive care, with full recovery.
Literature ReviewFive cases of ondansetron-induced TdP were reviewed. Patient ages ranged from 41 to 60 years, one case (20%) involved oral administration and four cases (80%) involved intravenous administration. Doses ranged from standard 4 mg to cumulative 36 mg infusions, with QTc intervals reaching up to 653 ms. Presenting events included TdP, ventricular tachycardia, and cardiac arrest. Symptom resolution and recovery were achieved in all cases following medical intervention and electrolyte correction.
ConclusionThis case highlights that standard-dose ondansetron can precipitate TdP in physiologically unstable patients.
Keywords Ondansetron Torsades de pointes QT prolongation Hypokalemia Drug-induced arrhythmia All subjects
Barw Medical Journal. 2026;4(1):60–64
-
Surgical Outcomes Following First Rib Resection for Neurogenic Thoracic Outlet Syndrome: A Systematic Review of 1,334 Operated Sides
Review Articles
Surgical Outcomes Following First Rib Resection for Neurogenic Thoracic Outlet Syndrome: A Systematic Review of 1,334 Operated Sides
IntroductionNeurogenic thoracic outlet syndrome (NTOS) is the most common subtype of thoracic outlet syndrome and results from compression of the brachial plexus within the thoracic outlet. First rib resection (FRR) is considered the cornerstone of surgical management in patients with refractory symptoms, although postoperative outcomes remain variably reported. This systematic review aimed to evaluate the outcomes, complications, and recurrence rates of FRR in the management of NTOS.
MethodsA systematic review was conducted using Google Scholar, supplemented by artificial intelligence-assisted searches. Original studies reporting postoperative outcomes following FRR for NTOS were included. Data regarding patient characteristics, surgical approaches, postoperative outcomes, complications, and recurrence were extracted and analyzed descriptively. Comparative analyses between surgical approaches were performed using Chi-square testing.
ResultsNineteen studies involving 1,334 operated sides were included. Most studies were cohort studies (73.68%). Females represented 75.44% of reported patients. Successful postoperative outcomes were observed in 87.08% of analyzable cases. No statistically significant difference in success or recurrence rates was identified between the open approaches. A total of 170 complications were recorded among operated sides managed via the transaxillary approach. Pneumothorax was the most frequently reported complication in both the transaxillary (n = 99, 20.58%) and supraclavicular (n = 7, 2.68%) approaches. The overall recurrence rate was 1.50%.
ConclusionFirst rib resection is a safe and effective surgical intervention for NTOS, yielding favorable outcomes with low recurrence across a broad range of operative approaches. Neither the choice of surgical approach nor the extent of rib resection significantly influences surgical success.
Keywords Surgical decompression Brachial plexus Transaxillary approach Supraclavicular approach Postoperative outcomes Recurrence All subjects
Barw Medical Journal. 2026;4(1):42–54
-
Pilarowski–Bjornsson Syndrome with Congenital Heart Defect: A Case Report and Literature Review
Case Reports
Pilarowski–Bjornsson Syndrome with Congenital Heart Defect: A Case Report and Literature Review
IntroductionPilarowski–Bjornsson syndrome (PILBOS) is a rare autosomal dominant neurodevelopmental disorder caused by heterozygous variants in chromodomain helicase DNA-binding protein 1 (CHD1), a gene encoding an adenosine triphosphate (ATP)-dependent chromatin remodeler. Since its initial description in 2018, only a limited number of cases have been reported in the literature.
Case PresentationA 4-month-old male infant presented with persistent hypotonia and recurrent focal seizures beginning in the neonatal period, accompanied by severe global developmental delay. Brain magnetic resonance imaging (MRI) was structurally normal. Whole exome sequencing identified a heterozygous de novo CHD1 variant (NM_001270.4: c.797C>T; p.Pro266Leu), classified as a variant of uncertain significance. Echocardiography revealed a medium-sized secundum atrial septal defect with right-sided chamber dilatation. The clinical course was complicated by recurrent lower respiratory tract infections and progressive respiratory distress.
Literature ReviewReview of eight previously reported cases confirms global developmental delay and hypotonia as universal features of PILBOS (8/8, 100%). Dysmorphic craniofacial findings were present in 7/8 (87.5%) cases, and seizures occurred in 3/8 (37.5%). Intellectual disability was confirmed in 3/8 (37.5%) and not assessable in a further 3/8 (37.5%). Respiratory complications were documented in 1/8 (12.5%) cases. De novo inheritance was confirmed in 4/8 (50%) cases. No structural cardiac defects have been documented in any previously reported case, and all 8/8 (100%) patients were alive at last follow-up.
ConclusionFindings from this case suggest that structural congenital heart defects may represent an underrecognized component of the PILBOS phenotypic spectrum. Further case reports and functional investigations are required to establish whether cardiac involvement constitutes a consistent feature of CHD1-related disease.
Keywords Chromodomain helicase DNA-binding Proteins Neurodevelopmental disorders Atrial septal defect Exome sequencing All subjects
Barw Medical Journal. 2026;4(1):55–59
-
Clinical Profile and Surgical Outcomes of Pediatric Umbilical Pilonidal Sinus
Original Articles
Clinical Profile and Surgical Outcomes of Pediatric Umbilical Pilonidal Sinus
IntroductionUmbilical pilonidal sinus (UPS) is a rare form of pilonidal disease (PNS) predominantly affecting young individuals. Owing to its low incidence, data on risk factors and optimal management remain limited. This study aimed to investigate UPS in the pediatric age group and evaluate the efficacy of surgical management.
MethodsA retrospective, single-center cohort study was conducted over five years, including patients aged ≤18 years diagnosed with UPS. Clinical, demographic, and risk factor data were collected from medical records. All patients underwent surgical management under local anesthesia, with follow-up to assess healing and recurrence. Descriptive statistical analysis was performed using SPSS version 27.0.
ResultsA total of 42 cases (mean age 16.4 ± 1.48 years) were included. Males comprised 22 (52.4%) of cases. Dense body hair was observed in 29 (69.0%) of patients, and 15 (35.7%) reported a positive family history, and obesity was common (median body mass index (BMI) was 25.9 (IQR: 22.5–29.0)). Surgical treatment achieved successful healing in 40 (95.2%) of cases, with a low recurrence rate of 1 (2.4%).
ConclusionSurgical management showed favorable outcomes with high healing and low recurrence rates, supporting its effectiveness in pediatric patients. However, larger multicenter studies are needed to clarify risk factors and optimize management strategies
Keywords Umbilical pilonidal sinus Pediatric Risk factors Surgical management All subjects
Barw Medical Journal. 2026;4(1):27–32
-
Clinicopathological Characteristics and Survival Outcomes of Breast Cancer in Young Women
Original Articles
Clinicopathological Characteristics and Survival Outcomes of Breast Cancer in Young Women
IntroductionBreast cancer in young women, defined as diagnosis before 40 years of age. It is characterized by poorer outcomes compared with older patients. Regional data on the disease in the Middle Eastern population remain limited. This study focused on the clinicopathological profile of young women with breast cancer.
MethodsThis retrospective, single-center cohort study was conducted between February 2018 and February 2025. Demographic, clinical, pathological, treatment, and follow-up data were extracted from electronic medical records. Inclusion criteria were women under 40 years diagnosed with primary breast cancer. Patients with incomplete records or without surgical treatment were excluded.
ResultsA total of 564 patients with a median age of 36 years (IQR: 5) were included. A breast mass was the predominant chief complaint (85.5%), and 74.7% presented within 3 months. Median tumor size was 25 mm. Invasive ductal carcinoma was the predominant subtype (88%). Triple-negative breast cancer was identified in 73 patients (12.9%), of which 76.1% were Grade III (p<0.001). Negative estrogen and progesterone receptor status was significantly associated with Grade III (p<0.001). Wide local excision was performed in 67.0% of cases. Overall survival was 98.5% at 60 months.
ConclusionHigh tumor grade was significantly associated with triple negative breast cancer, ER-negative, and PR-negative status, but not with HER2 status. Symptom duration showed no association with tumor size. Ki-67 was significantly higher in Grade III tumors, reinforcing the aggressive phenotype of breast cancer in young women
Keywords Breast Cancer Triple negative Prognosis Young women All subjects
Barw Medical Journal. 2026;4(1):19–26
-
Epithelial-Myoepithelial Carcinoma of Salivary Glands: A Tertiary Center Experience
Original Articles
Epithelial-Myoepithelial Carcinoma of Salivary Glands: A Tertiary Center Experience
IntroductionEpithelial-myoepithelial carcinoma (EMC) is a rare, biphasic malignant tumor affecting the salivary glands. It represents less than 1% of all salivary gland tumors. This study aims to present a single-center experience regarding the diagnosis, management, and prognosis of EMC.
MethodsThis study was conducted between February 2020 and December 2025. Patients with a histopathologically confirmed diagnosis of epithelial-myoepithelial carcinoma were identified. Complete medical records containing demographics, clinical presentation, imaging results, histological features, treatment approaches, and follow-up results were included in the cases.
ResultsFive patients were identified, of which 4 (80%) were females. The mean age was 56 ± 9.38 years. Two patients (40%) presented with painless post-auricular swelling, 1 (20%) with submandibular swelling, and 2 (40%) were incidental findings. Histopathological examination confirmed EMC in all cases. Free margins were achieved in 3 tumors (60%). No recurrence was observed during a mean follow-up of 24 ± 28.92 months.
ConclusionEpithelial-myoepithelial carcinoma is a very rare tumor. It requires histopathological evaluation for accurate diagnosis, and complete surgical excision offers favorable short-term outcomes. Further studies are needed to better define its clinical characteristics and outcomes.
Keywords Epithelial-myoepithelial carcinoma Salivary gland neoplasm Parotidectomy Biphasic tumor All subjects
Barw Medical Journal. 2026;4(1):13–18
-
Social Media Use in Neurology: An Analysis of Alzheimer's Information on TikTok with Emphasis on Role of Healthcare Professionals
Original Articles
Social Media Use in Neurology: An Analysis of Alzheimer's Information on TikTok with Emphasis on Role of Healthcare Professionals
IntroductionAlzheimer's disease (AD) is the most common neurodegenerative cause of dementia. Social media has become a major source of information for patients and families. This study is the first to explore the quality, source, and content of AD videos on TikTok with emphasis on the role of healthcare professionals (HCPs).
MethodsA cross-sectional analysis was conducted on April 30, 2025, on AD videos on TikTok, including the data of usernames, video title, date of posting, and days since uploaded, video duration, video sources or uploader, content type, and engagement metrics. The DISCERN tool, a 15-item questionnaire for judging the quality of written consumer health information on treatment choices, was used to evaluate the quality of health information. Statistical analysis was conducted using R Statistical software.
ResultsIn total, 100 videos of the hashtag Alzheimer's were deemed eligible with median (interquartile range) engagement metrics: 4201.00 (300.25 to 66775.00) likes, 131.50 (13.00 to 1071.00) comments, and 438.00 (43.00 to 3414.00) shares. HCPs streamed only 33% of videos. There were videos about therapy suggestions (10%), disease descriptions (30%), and lifestyle (16%). The majority had poor (42%) and very poor (39%) quality. Videos by HCPs had more medical content with higher quality despite insignificant differences in engagement compared to non-HCP videos.
ConclusionThis study revealed an overall poor quality of public information on AD on TikTok, with a paucity of essential information, with minor contributions from HCPs. HCPs and organizations should provide creative, systematic plans to enhance public awareness on social media.
Keywords Alzheimer Public health TikTok Social Media Dementia Awareness All subjects
Barw Medical Journal. 2026;4(1):6–12
Subjects
Hydatid cyst Artificial intelligence ChatGPT AI Management Metastasis Antimicrobial resistance Cancer COVID-19 Echinococcosis
The 71 subjects this journal has published on more than once. A further 458 have been used a single time.
What is being read
Most read
- Differential Diagnosis of Neurogenic Thoracic Outlet Syndrome: A Review 16,844 reads
- CaReL Guidelines: A Consensus-Based Guideline on Case Reports and Literature Review (CaReL) 11,743 reads
- Blood Cross Matching Without Anti-Human Globulin (AHG) and Bovine Serum: A New Interest for an Old Idea 6,716 reads
- Defining the Scientist: A Consensus-Based Approach 6,415 reads
- Renaming the Problem: Why ‘Non-Recommended Journals’ Is Preferable To ‘Predatory’ in Academic Publishing 6,384 reads
Most cited
- Kscien’s List; A New Strategy to Discourage Predatory Journals and Publishers (Second Version) 51 citations
- Predatory Publishing Lists: A Review on the Ongoing Battle Against Fraudulent Actions 48 citations
- CaReL Guidelines: A Consensus-Based Guideline on Case Reports and Literature Review (CaReL) 34 citations
- Non-Recommended Publishing Lists: Strategies for Detecting Deceitful Journals 17 citations
- Cancer Publications in One Year (2023): A Cross-Sectional Study 13 citations
Citations are Crossref’s count on 8 November 2026.