CORRELATION OF SERUM FERRITIN AND LDH ON CRITICALLY ILL PATIENTS OF COVID-19 DISEASE DURING 1ST AND 2ND WAVE OF COVID 19 PANDEMIC IN TERTIARY CARE HOSPITAL, INDIA

In both the earlier waves of COVID-19 variants, severe and fatal respiratory disease like acute respiratory distress syndrome (ARDS) became more fatal in population with comorbid conditions. Therefore, early identi?cation of severe COVID-19 is very important for individual's precise management, including antiviral, oxygen support and intensive care unit (ICU) management. First case of COVID-19 got reported in the medical record of India on 30th January 2020 in a student who had returned from Wuhan, China. In 2020 and 2021 it was found that individuals with increased serum ferritin and LDH level landed up with severe and very severe COVID-19 if not treated timely and correctly. So correlation between S. Ferritin and LDH in 1st and 2nd wave was required to evaluate the condition of patients who remained admitted in critical care unit with or without comorbid conditions. This is hospital based cross- sectional observational study on 50-50 (total-100) critically ill patients admitted during 2020 and 2021 respectively. We found that In 2020 during the 1st wave serum LDH and serum Ferritin levels were signi?cantly high with the mean value of 481.65 U/L and 532.56 ng/ml respectively and in 2021 during 2nd wave serum LDH and serum Ferritin levels were again signi?cantly high with the mean value of 488.43 U/L and 667.27 ng/ml respectively. In 2020 patients with comorbid conditions showed S. LDH and Ferritin mean value of 543.47 U/L and 582.63 ng/ml respectively and in 2021 during 2nd wave it showed S.LDH and Ferritin levels mean value of 672.72 U/L and 727.38 ng/ml respectively. Both in?ammatory markers were signi?cantly more increased in the critically ill patients who presented with co-morbidities. This study will provide improved con?dence to health workers working in remote areas and COVID-19 hospitals in predicting transfer of COVID-19 patients to tertiary care hospitals for critical care management at the earliest.

Antimicrobial Utilization Study in a Neurology Setting

Background : Measuring antimicrobial consumption is necessary to understand the volume and patterns of use, to design appropriate interventions to reduce and rationalize its use. Materials and Methods : The antimicrobial consumption in Neurology ICU and IPD were measured over a 5-year period using WHO Defined Daily Dose (DDD) methodology. Results : There was an increasing trend in Antimicrobial Consumption (AMC) from 125.7 to 155.5 DDDs/100 days over 5 years with highest consumption in 2017-2018 (190.7 DDDs). The consumption of Watch group of antibiotics was higher than access group antibiotics both in ICU and IPD and constituted more than 75% of total antibiotic consumption. Conclusions : The initiation of empiric therapy though may be necessary depending on the patients condition, however, duration of antibiotic therapy and reducing usage of prophylactic antibiotics for aspiration pneumonia and reducing consumption of Watch group of antibiotics were identified as stewardship opportunities. Feedback on AMC data and persuasive educational interventions to rationalize and reduce antimicrobial use are required.

Current state of non-hematologic cancer-associated thrombosis at a tertiary care hospital in India

Abstract Introduction Cancer-associated thrombosis is a leading cause of morbidity and mortality in malignancy patients. Prophylactic anticoagulation is under-utilized and the cost of low-molecular-weight heparin (LMWH) and direct oral anticoagulants is a major barrier in developing countries. Material and methods A retrospective analysis was performed of all cancer-associated thrombosis patients attending the thrombosis clinic at a tertiary-level referral hospital based in North India between 2011 and 2015. Patient demographics and disease-related parameters were collected and analyzed. Results A total of 771 patients attended the thrombosis clinic during study period, of which 64 cases were malignancy-associated. Of these, 56% of the patients were female and 20% were bedridden. The median age was 48.5 years, adenocarcinoma (48%) being the most common histological subtype. Gynecological malignancies (30%) were the most common malignancies, followed by genitourinary (11%) malignancies. Most of the cases occurred during first year of diagnosis (51%), and only 14% occurred after 3 years. Most of the patients were on combined treatment. Almost 40% of the patients developed thrombosis within 30 days of surgical treatment. Lower limb thrombosis was the most commonly seen type (56%), while abdominal and pulmonary thrombosis were both seen in 5%. Patients were managed with LMWH and vitamin K antagonists (84.3%) and only 6.25% with LMWH alone. Direct oral anticoagulants were not commonly used during the study period. Discussion At the hospital studied, most of the cases occurred early in the disease course. Postoperative prophylaxis could have contributed towards reducing thrombosis in the peri-operative period. Early suspicion and prompt treatment can improve quality of life in such patients.

Histopathological-spectrum-of-brain-lesions-in-patients-attending-to-rims-ranchi—a-retrospective-study

Background- The CNS space occupying lesions cause grave life-threatening outcomes irrespective of their nature as they grow in a confined space and are present close to vital structures Hence, it is of great importance to establish the accurate diagnosis for proper and timely neurosurgical intervention Tumours of central nervous system (CNS) are reported to be less than 2 % of all malignancies. In India, CNS tumours constitute about 1.9 % of all tumours. - AMethod retrospective study carried out in RIMS hospital for all the brain tissue specimen that have come for the histopathological examination, for a duration of one year (February2021 - January2022) among 78 cases of CNS lesions collected from archives of Department of Pathology. Astrocytoma was the most common entity followed by Meningioma whileResults- 2.56% cases were metastatic in this study sample. The present study helps to provide informationConclusion- regarding the disease burden in our area. This study attempts to categorise various CNS neoplasms as per recent WHO classification (2016) which has not only diagnostic implication but also has significant prognosis and predictive value

Unraveling Prostaglandin and NLRP3 Inflammasomemediated Pathways of Primary Dysmenorrhea and the Role of Mefenamic Acid and Its Combinations

Painful menstrual cramps during or around the time of the monthly cycle are known as dysmenorrhea. The estimated global prevalence in women of reproductive age ranges from 45% to 95%. It has a significant negative impact on regular activities and productivity at work. However, despite the severe consequences on quality of life, primary dysmenorrhea (PD) is underdiagnosed. Dysmenorrhea has complex pathogenesis. It involves the release of prostaglandins and activation of the nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3) inflammasome and also includes the involvement of other mediators such as bradykinin, histamine and acetylcholine. Even though nonsteroidal anti-inflammatory drugs (NSAIDs) remain the most common type of pain medication, the question of which one should be the most preferred is still open to debate. The current review examines the existing evidence for the pathogenesis of PD and makes evidence based and clinical experience based recommendations for the use of mefenamic acid and its combination in the treatment of dysmenorrhea. Mefenamic acid alleviates PD by inhibiting endometrial prostaglandin formation, restoring normal uterine activity, and reducing the inflammatory response by inhibiting the NLRP3 inflammasome and reducing the release of cytokines such as interleukin (IL)-1?. It is also known to have bradykinin antagonist activity. Dicyclomine has a dual action of blocking the muscarinic action of acetylcholine in postganglionic parasympathetic effect or regions and acting directly on uterine smooth muscle by blocking bradykinin and histamine receptors to relieve spasms. According to the experts, mefenamic acid and dicyclomine act synergistically by acting on the different pathways of dysmenorrhea by blocking multifactorial agents attributed to the cause of dysmenorrhea. Hence, the combination of mefenamic acid and dicyclomine should be the preferred treatment option for dysmenorrhea.

Challenges with Adjuvant Radiation for Intracranial Chondrosarcoma in Pregnancy

Background: Managing a brain tumor during pregnancy is a highly confusing and challenging situation, complicated by several technical, medical, ethical, and sociocultural concerns. The interests of the mother and child are often pitted against each other, for which legal opinion may occasionally be needed. Case Report?We present the report of a young lady with intracranial well-differentiated chondrosarcoma who was determined to be pregnant in the immediate postoperative period. We discuss the management of challenges and dilemmas in devising optimum therapy, and the modifications and care required at each step to help safeguard maternal and fetal health. Risks with therapeutic radiation and measures to assess and pre-empt fetal doses that may assist decision-making are also discussed. Conclusion?Radiation therapy during pregnancy is challenging and requires multidisciplinary involvement and psychosocial support for the patient and family.

Psychological trauma and depression in recovered COVID-19 patients: a telecommunication based observational study

Abstract Introduction Coronavirus disease 2019 (COVID-19) is adversely affecting the mental health of patients infected with the virus and the psychological impact on recovered COVID-19 patients is unclear. Objectives The study aimed to assess posttraumatic stress disorder (PTSD) and depression among COVID-19 patients after recovery from the disease. Methods This cross-sectional study was conducted from November 9, 2020, to December 23, 2020. The study used a telemedicine model to enroll recovered COVID-19 patients from a database of patients provided by the health authorities. The National Stressful Events Survey PTSD Short Scale (NSESSS) for adults was used to assess PTSD symptoms and the Patient Health Questionnaire (PHQ-9) was used to assess depression. Results The study enrolled 503 recovered COVID-19 patients with a mean age of 41.90 years. The majority were asymptomatic (64.6%), while 21.5% had had moderate to severe forms of the disease. Prevalence rates of PTSD symptoms and depression were 56.9 and 29% respectively. COVID-19 patients with severe forms of the disease were significantly more affected by PTSD symptoms (vs. mild, odds ratio [OR] = 18.7, 95%confidence interval [CI] 9.9-35.5) and depression (vs. mild, OR = 19.8, 95% CI 9.9-39.5). Similarly, patients who required oxygen or ventilator support reported significantly higher rates of PTSD symptoms (vs. managed at home, OR = 17.4, 95% CI 8.3-36.4) and depression (vs. managed at home, OR = 22.0, 95% CI 10.1-47.7). Conclusion This study reports that recovered COVID-19 patients suffered from a significant amount of depression and experienced significant PTSD symptoms. It will help with addressing a major psychological concern among the recovered subjects.

A telepathology based screening tool for COVID-19 by leveraging morphological changes related to leukocytes in peripheral blood smears

As we approach the aftermath of a global pandemic caused by Severe Acute Respiratory Syndrome-Corona Virus (SARS-CoV-2), the importance of quickly developing rapid screening tests has become very clear from the point of view of containment and also saving lives. Here, we present an explorative study to develop a telepathology-based screening tool using peripheral blood smears (PBS) to identify Coronavirus Disease (COVID-19)-positive cases from a group of 138 patients with flu-like symptoms, consisting of 82 positive and 56 negative samples. Stained blood smear slides were imaged using an automated slide scanner (AI 100) and the images uploaded to the cloud were analyzed by a pathologist to generate semi-quantitative leukocyte morphology-related data. These telepathology data were compared with the data generated from manual microscopy of the same set of smear slides and also the same pathologist. Besides good correlation between the data from telepathology and manual microscopy, we were able to achieve a sensitivity and specificity of 0.83 and 0.71, respectively, for identifying positive and negative COVID-19 cases using a six-parameter combination associated with leukocyte morphology. The morphological features included plasmacytoid cells, neutrophil dysplastic promyelocyte, neutrophil blast-like cells, apoptotic cells, smudged neutrophil, and neutrophil-to-immature granulocyte ratio. Although Polymerase Chain Reaction (PCR) and antibody tests have a superior performance, the PBS-based telepathology tool presented here has the potential to be an interim screening tool in resource-limited settings in underdeveloped and developing countries.

Biofabrication and optimization of silver nanoparticles using Campsis sp. to explore their antimicrobial properties

Plant mediated green synthesis of silver nanoparticles (AgNPs) holds promising applications in the field of Biomedicine, Food packaging and Wound healing. In the present investigation, biofabrication of AgNPs was performed using the aqueous extracts of Campsis sp. (Family Bignoniaceae) leaves and flowers growing in the premises of Kirori Mal College, University of Delhi, Delhi. Optimization of AgNPs was performed to analyse the varying effect of pH (6.0, 8.0, 10.0) and silver salt concentration (2mM, 4Mm and 6Mm) in controlling the shape and size of AgNPs which in turn governs their further applications. Interestingly, change in colour of the reaction mixture from pale yellow to reddish brown indicated the formation of AgNPs. These AgNPs were further characterized by UV-Visible spectroscopy and showed peak in the range of 400-450 nm which confirmed the synthesis of silver nanoparticles. Dynamic light scattering and zeta potential analysis (DLS-Zeta) confirmed the size of AgNPs around 200-300 nm. A significant zone of inhibition was observed for both Staphylococcus aureus (gram-positive) and Escherichia coli (gram-negative) bacterial strains which revealed the antimicrobial potential of Campsis sp. AgNPs. Therefore, Campsis AgNPs may provide a green, eco-sustainable alternate method for sustainable production of nanomaterials for biomedical applications. These AgNPs may also show tremendous applications in food packaging, wound healing and biomedical fields.

Engineered nanoparticles (ENPs): Unexplored potential and limitations

The rapid growing industry of global economic importance is exploring the novel material synthesized at the nanoscale. Engineered nanoparticles (ENPs) have been manufactured with specific shape, size, surface properties and unique functionalities such as catalytic behaviour, increased strength, improved thermal and electrical conductivity. These advancements have opened the door to new applications in biomedicine, nanoenergetic materials and functional nanocomposites including cancer therapy, drug delivery, tissue engineering, regenerative medicine, biomolecule detection, and antimicrobial activities. In cancer therapies, nanoparticulate delivery systems allow ENPs greater penetration of therapeutic and diagnostic substances within the body while posing fewer risks than conventional cancer therapies. Evidences suggested that ENPs offer some substantial danger to the environment by its toxicological effects when they are exposed to the environment, which leads to the chronic issues of nanopollution. The aquatic environment is at the greatest risk from ENPs, as it serves as a sink for nearly all environmental contaminants. Despite these challenges, ENPs holds promise to in different field as well as minimize environmental pollution, by employing the innovative environmental remediation methods. There are gaps in understanding the fate of ENPs in the environment hence more stringent and critical research is the need of the hour. It also call for the advancement of tools and techniques that can accurately quantify and analyze the uptake of ENPs into biological systems.This review includes the different types of ENPs their sources and physiochemical characteristics and the ultimate fate of these ENPs in the environment.

Case report -Cesarean scar ectopic pregnancy

Cesarean scar ectopic pregnancy is one of the rarest of all ectopic pregnancy increase in number of cesarean section leads to increase in number of cesarean scar ectopic pregnancy. Early diagnosis and prompt management help in reducing mortality and morbidity occuring due to scar ectopic pregnancy. We are reporting a rare case of cesarean scar ectopic pregnancy G5P3L3D1 with period of gestation 7 weeks 3 days with previous all 4 deliveries by cesarean section. Cesarean scar ectopic pregnancy are life threatening as they pose a great risk of maternal hemorrhage as the patient vital are the stable patient managed medically with injection Methotrexate

Effect of obesity on Left ventricular diastolic function in young normotensive obese individuals.

Background: The prevalence of obesity is increasing at an alarming rate even in the developing country like India. Increased adiposity is the risk factor for the development of hypertension, diabetes and cardiovascular disease. The excess fat mass associated with obesity is known to cause haemodynamic changes like increase in preload and after load and also peripheral resistance. The study aims to evaluate the association between the obesity and Diastolic function using echocardiography in uncomplicated young obese individuals. Materials and Methods: The study was conducted in age matched 24 young male obese individuals and 26 male controls. Anthropometric parameters like height (cms), weight (kgs) were measured. BMI was calculated. Controls with BMI of 18.50 – 24.99 kg/m2 , Obese individuals with BMI ? 30 kg/m2 . Echocardiograms were performed using GE Vivid T 8 by standard techniques. The early diastolic (E) and atrial (A) velocities were measured and the E/A ratio was calculated. The deceleration time (in ms) was also assessed. Statistical analysis was done using ‘t’ test Results: The mean values of the early diastolic (E) velocity and E/A ratio were lesser in the group of obese individuals when compared with the controls and was statistically significant. Deceleration time and left ventricular end diastolic volume were greater in obese individuals. Conclusion: The present study suggests a significant decrease in the diastolic function in obese individuals when other risk factors are excluded. So obesity is found to have detriment on diastolic function and may lead to cardiac failure. Echocardiographic study should be included in the evaluation of obesity for early detection diastolic dysfunction. Preventive measures should be taken to decrease the morbidity and mortality associated with obesity.

A comparative study of antibody response, virus neutralization efficiency & metabolites in SARS-CoV-2-infected adults & children

Background & objectives: COVID-19 has been a global pandemic since early 2020. It has diverse clinical manifestations, but consistent immunological and metabolic correlates of disease severity and protection are not clear. This study was undertaken to compare seropositivity rate, antibody levels against nucleocapsid and spike proteins, virus neutralization and metabolites between adult and child COVID-19 patients. Methods: Plasma samples from naïve control (n=14) and reverse transcription (RT)-PCR positive COVID-19 participants (n=132) were tested for reactivity with nucleocapsid and spike proteins by ELISA, neutralization of SARS-CoV-2 infectivity in Vero cells and metabolites by 1H nuclear magnetic resonance (NMR) spectroscopy. Results: An ELISA platform was developed using nucleocapsid and spike proteins for COVID-19 serosurvey. The participants showed greater seropositivity for nucleocapsid (72%) than spike (55.3%), and males showed higher seropositivity than females for both the proteins. Antibody levels to both the proteins were higher in intensive care unit (ICU) than ward patients. Children showed lower seropositivity and antibody levels than adults. In contrast to ICU adults (81.3%), ICU children (33.3%) showed lower seropositivity for spike. Notably, the neutralization efficiency correlated with levels of anti-nucleocapsid antibodies. The levels of plasma metabolites were perturbed differentially in COVID-19 patients as compared with the naive controls. Interpretation & conclusions: Our results reflect the complexity of human immune response and metabolome to SARS-CoV-2 infection. While innate and cellular immune responses are likely to be a major determinant of disease severity and protection, antibodies to multiple viral proteins likely affect COVID-19 pathogenesis. In children, not adults, lower seropositivity rate for spike was associated with disease severity

Granular cell ameloblastoma: A rare and unique variant

Ameloblastoma is a slow-growing and locally invasive epithelial odontogenic tumor of the jaw that runs a benign course in most cases. Granular cell ameloblastoma is a rare subtype of ameloblastoma, showing the granular transformation of its cytoplasm. It is considered as an aggressive variant of ameloblastoma. Herein, we report the case of a 34-year-old male patient who presented with a swelling in the left cheek for a 1-year duration with a recent rapid increase in size. Examination showed a 4 � 3 cm growth involving the left buccal mucosa and retromolar area. Imaging studies showed expansile lytic lesion mandible. Biopsy revealed neoplasm with odontogenic epithelial islands showing peripheral palisading of tall columnar cells with reversal of polarity and the center of the islands showing stellate reticulum-like cells which were markedly replaced by granular cells. Granular cells can appear in various odontogenic and non-odontogenic tumors. When there is extensive granular cell change in ameloblastoma, it should be differentiated from other oral lesions with granular cells including granular cell odontogenic tumor, granular cell tumor, and congenital epulis.

Environmental nanotechnological applications for Sustainable agriculture

Agriculture and society are intertwined. Agriculture is necessary for human survival and social sustainability in India. Eco-friendly agriculture practices nurture ecosystems to solve current societal issues. Indian ecosystems are marred by pollution, imbalance, climate changes, food crisis, various diseases, and mal-nourishment continue as a major concern. The traditional environmental remedial strategies appear relatively ineffective in the ever expanding use of pollutants that pervade the water, air and soil environment. Nanotechnology provides an efficient, environmentally friendly and cost-effective solutions to the global sustainability challenges that society is facing. Nanotechnology utilizes nanomaterials that have remarkable physical and chemical features to make smart functional materials for developing sustainable technologies. Nanotechnology seems to be very promising in sustainable environment development, sustainable agriculture, renewable and economically energy alternative through use of nanomaterials for detection, prevention, and removing pollutants. The development of nanotechnology in India has huge potential to address the challenges like providing drinking water, healthcare, nano-based industry and sustainable agriculture. This review highlights the recent nanotechnology applications to meet the global challenges in providing clean energy technology, water purification, and greenhouse gases management. In addition, effort has been made to analyse the opportunities and limitations in engineered nanomaterials safety, solid waste management, reducing pollution of air water and soil.

An insight into the altered ophthalmic dynamics during the COVID-19 pandemic

Purpose: The objective of this survey?based study was to examine the effects of personal protective measures taken at the level of instrument and surgeon during the pandemic on the optics in ophthalmology. Methods: The study involved an online questionnaire of 24 questions which was distributed to ophthalmologists practicing in several hospitals, including residents and fellows undergoing training in ophthalmology in India. The responses were collected through an online data collection tool (Google forms). The participants could choose from multiple options provided to them in each question. Results: A total of 285 participants out of 296 had used modified methods for examining and performing surgical procedures during the pandemic, while 78.7% (265) of the participants acknowledged having encountered difficulty in interpreting the ocular findings of patients while examining in personal protective equipment. Moreover, 58.7% (198) of our study respondents also reported that there was significant worsening of the quality of ophthalmological examination with pandemic?appropriate measures and 84.8% (286) of our study participants also felt that these measures have significantly added to the time of examination, hence increasing the risk of exposure to both patient and doctor. Conclusion: The workplace study has highlighted the crucial aspects of optics in ophthalmology during the pandemic. The protective measures taken during the pandemic have significantly worsened the quality of ophthalmological examination and increased the time taken to perform outpatient department?based and surgical procedures in ophthalmology

Effectiveness and Implications of a Structured Hands-on Training on OSCE for Nursing faculties: A pilot project by Trained Nurse's Association of India

Nursing is one of the professions which require knowledge along with clinical competence to provide high quality nursing care. Objective Structured Clinical Examination (OSCE) and Objective Strucured Practical Examination (OSPE) methods of evaluation have emerged as an alternative to traditional evaluation methods for the skills assessment. This study was planned to train nursing faculties on OSCE and evaluate its effectiveness. The primary objective of the for nursing faculties on knowledge regarding OSCE. A one group pretest-posttest design with a quantitative research approach was used. Convenient sampling method was used include 27 faculties from all the available colleges of Nursing in NCT of Delhi. A structured 15-item questionnaire with multiple choice questions, each comprising four responses with one correct response was used to evaluate the knowledge of the participants regarding OSCE. The twoday training programme comprised the theory sessions and demonstration of OSCE stations ties. The study suggests that there is a need to develop a structured training programme and conduct training for faculties across the country to bring in uniformity in implementation of OSCE method of evaluation in colleges.

Changing Paradigm in the epidemiology of Japanese encephalitis in India

Japanese encephalitis (JE) is a very serious public health problem in India and the conducive environment permit its emergence in non-endemic areas in the country. There are constant changes taking place in the pattern of current agricultural practices and vector breeding habitats which had far-reaching consequences on the epidemiology of JE and the severity of epidemic outbreaks today. Due to the continuous ecological changes taking place, vectors changed in their breeding dynamics, feeding, and resting behavior and started invading previously non-endemic areas. JE has recently spread to new territories due to land-use changes, including forest fragmentation and concentrated livestock production. Changes in the livestock population decreased the cattle pig ratio which enhanced the Japanese encephalitis virus (JEV) infection. This review brings forth the present widespread changes encountered that grossly impact the risk of infection in many places for the emergence of Japanese encephalitis and to address the implications for its control.

Mosaic Variant of Turner Syndrome

Turner syndrome is the most common chromosomal abnormality leading to gonadal failure and primary amenorrhea. While half of the cases have monosomy of chromosome X, the remaining exhibit mosaicism resulting in wide variation of phenotypic characteristics and clinical manifestations. We present a case of a 24-year-old female with mosaic variant Turner syndrome. The diagnosis was confirmed by karyotype analysis and laparoscopy.

A Study On Working Capital Management In Pazhavoor Primary Agriculture Co-Operative Credit Society Ltd, Pazhavoor, Tirunelveli, Tamil Nadu.

The title of the research article is “A Study on Working Capital Management in Pazhavoor Primary Agriculture Co- operative Credit Society Ltd., Pazhavoor, Tirunelveli, Tamil Nadu.” Working capital management involves the relationship between a company's short-term assets and its short-term liabilities. The goal of working capital management is to ensure that a company is able to continue its operation and that it has sufficient ability to satisfy both maturing short-term debt and upcoming operational expenses. The management of working capital involves managing inventories, accounts receivable and payable and cash management. Further the study is based on last five years annual reports of Pazhavoor Primary Co-operative Society. The objective of the study is to analyze the working capital position in Pazhavoor Primary Co-operative Society and to analyze the profitability and solvency position of the Pazhavoor Primary Co-operative Society. The study of working capital is based on tools like Ratio analysis, statement of changes in working capital, comparative balance sheet and trend analysis. By analyzing the topic of working capital management in Pazhavoor Primary Co-operative Bank Ltd. It concludes that the bank is having less working capital in the year 2019 but in the year 2020 the working capital is increasing, So the bank maintains the constant working capital which helps perform the day-to-day business by increasing the current asset.