Pranaya Gaddamedhi

                 This is online E log book to discuss our patient's de-identified health data shared after taking his/her/guardian's signed informed consent. Here we discuss our individual patient's problems through series of inputs from available global online community of experts with an aim to solve those patients clinical problems with collective current best evidence based inputsThis e-log book also reflects my patient centered online learning portfolio and your valuable inputs on comment box is welcome".             A 52 yr old male resident of Mothkur, farmer by occupation came to the OPD with chief complaints of shortness of breath , and swelling on both legs and there was decreased urine output . History of Present illness :       Patient was apparently asymptomatic 1 month back . Then he complained of bilateral pedal edema which was gradually progressive pitting type . He also complained of decreased urine output . This caused him great disstress and consider