Wandering intrauterine contraceptive device: An unusual travel to the sigmoid colon

Intrauterine contraceptive device (IUCD) is common choice for contraception. Migration of IUCD is one of the complications that are encountered. Here we report a case of IUCD migration to the sigmoid colon. A 39-year-old Malay lady carrying a copper T type of IUCD presented with missing thread then underwent examination under anaesthesia, proceeded to hysteroscopy but failed removal. Abdominal ultrasound detected it in the left lower quadrant of abdomen. She then underwent diagnostic laparoscopy where the device was found to be embedded in the sigmoid colon. Technical difficulty necessitated conversion to mini laparotomy and sigmoidotomy to remove the IUCD and the bowel closed primarily. IUCD is a relatively simple and safe contraceptive procedure but possible complications are bleeding and pain that usually co-exist, pelvic infection, expulsion and perforation. Investigations should be based on clinical suspicion and migrated IUCD in symptomatic patients should be surgically removed whereas, asymptomatic patients can be managed conservatively under certain circumstances. However in the presence of a concurrent pathology that requires exploration then retrieval of the migrated IUCD should be undertaken.

Antibacterial potential of sponge endosymbiont marine Enterobacter sp at Kavaratti Island, Lakshadweep archipelago

OBJECTIVE@#To isolate antibacterial potential of sponge endosymbiotic bacteria from marine sponges at Lakshadweep archipelago. Also to identify the potent bacteria by 16s rDNA sequencing and determine the antibacterial activity against clinical pathogens by MIC.@*METHODS@#Sponge samples was collected from sub-tidal habitats at Kavaratti Island and identified. The endosymbiotic bacteria were isolated and selected potential bacteria which show antibacterial activity in preliminary screening against clinical pathogens Staphylococcus aureus (S. aureus), Escherichia coli (E. coli), Salmonella typhi (S. typhi), Klebsiella pneumoniea (K. pneumoniea) and Streptococcus sp. by disc diffusion assay. The crude extracts of potential bacteria LB3 was tested against clinical pathogens by MIC. The LB3 strain was identified by 16s rDNA sequencing, 1 111 bp was submitted in NCBI (HQ589912) and constructed phylogenetic tree.@*RESULTS@#Sponge sample was identified as Dysidea granulosa (D. granulosa) and potential bacteria LB3 identified as Enterobacter sp TTAG. Preliminary screening of sponge isolates against clinical pathogens, LB3 strain was selected as potential producer of secondary metabolites and crude extract was implies on MIC of LB3 have confirmed with lowest concentration of 5.0 mg/mL in broth medium influence of crude extract on growth inhibitory activity after 5 h of incubation period and completed the inhibitory activity at 15 h.@*CONCLUSIONS@#The present study concluded that phylogenetic analysis of endosymbiotic bacteria Enterobacter sp from sponge D. granulosa of Lakshadweep islands showed significant antibacterial activity against clinical bacterial pathogens.