The blood glucose, total serum cholesterol, High Density Lipoprotein (HDL) and Triglyceride (TRIG) levels of all rats in each group were determined before induction, post-induction with alloxan and post treatment with various concentrations of extract and standard drug. The alloxan diabetic rats treated with gliberclamide and aqueous leaf extract of Annona muricata showed average means of body weights as; (235.73±3.14a, 263.94±2.25a and 236.5±1.74a) respectively after 4 weeks of treatment. The Glucose level revealed; 168.43±5.06e, 65.29±4.57f and 57.86±3.93e respectively. Lipid profile raised significantly post exposure of diabetic rats to both standard drug and extract after 4 weeks of treatment. Therefore, A. muricata compared favorably with the standard drug in the context of diabetes management.

Vesicouterine fistula as described by Youssef manifests with amenorrhea, and cyclic haematuria (menouria) without urinary incontinence commonly following caesarean section. Other aetiologies have been reported for this disease. The post-caesarean section gossypiboma, a dual aetiology causing this condition is rare and can make its presentation atypical, thus posing a diagnostic dilemma. The clinical evaluation alone in the atypical presentation of the vesicouterine fistula is insufficient except complemented by imaging investigations and endoscopic examination of the related organs. We report a case of vesicouterine fistula that was managed initially as chronic pelvic inflammatory disease despite urinary incontinence until further evaluation including a transvaginal ultrasound scan and urethrocystoscopy raised an index of suspicion of a vesical mass suggestive of gossypiboma. The mass was confirmed to be a foreign body, an abdominal gauze pack, or gossypiboma. Its removal and repair of the vesicouterine fistula were associated with a satisfactory outcome.