RESUMO
INTRODUCTION AND IMPORTANCE: Cystic hygromas are congenital lymphangiomas that arise from a developmental anomaly in the lymphatic system. Typically detected in early childhood, their incidence in adolescents and at the chest wall or axillary area is rare. CASE PRESENTATION: We report two cases, a 14-year-old male child (Case I) and a 1-year-old male infant (Case II), who presented with swelling in unusual locations, the right axillary region and the right anterolateral chest wall respectively. Local examination findings were indicative of a cystic hygroma in the first case, while in the second case, characteristic transillumination was not seen due to a complication: hemorrhage within the cyst. The diagnoses were established after a correlation of the patient's history, and clinical findings with radiological investigations. Both underwent surgical intervention and had no complications. Histopathology of the post-operative specimens confirmed the diagnoses. DISCUSSION: The diagnosis of cystic hygroma is made in the totality of thorough history taking, clinical examination, and radiological and histopathological investigations. Though most cases typically manifest before the age of two years and in the cervicofacial area, unusual locations and delayed presentation can occur. Surgical excision is a safe and effective treatment modality for these lesions. CONCLUSION: Although a rare entity, cystic hygroma should be considered a possible differential diagnosis of any swelling in the pediatric population.
RESUMO
Forest cover is the primary determinant of elephant distribution, thus, understanding forest loss and fragmentation is crucial for elephant conservation. We assessed deforestation and patterns of forest fragmentation between 1930 and 2020 in Chure Terai Madhesh Lanscape (CTML) which covers the entire elephant range in Nepal. Forest cover maps and fragmentation matrices were generated using multi-source data (Topographic maps and Landsat satellite images of 1930, 1975, 2000, and 2020) and spatiotemporal change was quantified. At present, 19,069 km2 forest cover in CTML is available as the elephant habitat in Nepal. Overall, 21.5% of elephant habitat was lost between 1930 and 2020, with a larger (12.3%) forest cover loss between 1930 and 1975. Area of the large forests (Core 3) has decreased by 43.08% whereas smaller patches (Core 2, Core 1, edge and patch forests) has increased multifold between 1930 and 2020. The continued habitat loss and fragmentation probably fragmented elephant populations during the last century and made them insular with long-term ramifications for elephant conservation and human-elephant conflict. Given the substantial loss in forest cover and high levels of fragmentation, improving the resilience of elephant populations in Nepal would urgently require habitat and corridor restoration to enable the movement of elephants.
