Title: Migrated Intra-Uterine Device to Infra-umbilical skin: A rare Case Report
Version: 2 Date: 13 Nov 2024
Reviewer:  Antonio Bandala-Jacques
Reviewer's report:
Dear authors -
I have re-reviewed your manuscript, and offer the following comments and suggestions:
A) The opening sentence "Intrauterine device (IUD) is one of the most effective". I would
pluralize the subject to make it a fact regarding IUDs. It is unusual to refer to them as a singular
noun
B) In "These methods have several advantages including ease of use, patient satisfaction,
relatively affordable cost in addition with the long-term use, and reversible nature"
You have not referred to any methods. I would rephrase to be more specific. Do you mean the
two IUDs you listed on the previous sentence? or IUDs in general.
C) In "The mechanism of Levonorgestrel containing devices for contraception is by thickening
of the cervical mucus thereby preventing sperm permeability"
-> Levonorgestrel is not a trademark, do not capitalize unless it it at the beginning of a sentence.
Also, this sentence is hard to read.
What about "Levonorgestrel-containing devices act by...."
D) In "Copper containing IUDs work by inhibition of fertilization and the endometrial
inflammatory reaction which hinders implantation "
Copper-containing should by hyphenated, else you are referring to copper that contains IUDs
E) The capitalization and grammatical issues mentioned in my prior comments are still there.
The manuscript requires significant style editing
F) You mention "The clinical presentation of misplaced device depends on its final anatomical
location at diagnosis. Misplaced device may be first incidentally detected with radiography being
ordered for other medical illness (10, 11)"
Would most of them not be detected by non-incidental radiography ordered after device
insertion? this might vary by location
G) I don;t understand your sentence "Hence, this report may help the current scientific
community understand IUD migration to other body parts than reported before will potentially
be possible."  before what will be potentially possible? Please rephrase
CASE
H) "The woman, a 38-year-old Para-VI mother,"
Besides the capitalization issue, this again reads like a medical record. You should explain what
Para-VI is
I ) What do you mean with "had regular monthly menstrual cycle. " when?
J) There are spacing issues in the case. Please address
K) you use the word "tinny". Do you mean its literal meaning of tin-related? Is this the word
you meant?
DISCUSSION
L) Please add citation for "Most women prefer to avoid hormone containing devices and prefer
copper containing IUDs. "
M After "Misplaced IUDs are rare in occurrence, may be asymptomatic, and remain for longer
period of time" please provide a measure of how common it is for IUDs to migrate.
N)  I don;t understand what you mean with "For the scientific community, we recommend
systematic review and meta-analysis on migrated and misplaced IUDs"
You are recommending scientists to read? perform? systematic reviews
O) Your final sentence
"This case report will help explain the potential migration sites of IUD are not limited to the
pelvis, abdomen, and anterior abdominal wall."
I don;t agreer with this. Your case report, as you mention, does not help explain it. Rather, it
informs on the existence of IUD migration outside the pelvis, abdomen, and anterior abdominal
wall. If so, are you positive there aren;t any reports of this?