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This is an 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 patient's clinical problems with collective current best evidence based inputs. This E log book also reflects my patient-centered online learning portfolio and your valuable inputs on the comment CASE PRESENTATION: 55year old male agricultural labour pt was apparently asymptomatic 15years ago,when he developed productive cough(increased on lying down) associated with sob grade 2-3, insidious onset,gradually progressive since 10years c/o pedal edema since 2months and decreased urine output since 1month abdominal distension since 2months,no fever,wt loss,appetite decreased burning micturation since 2months, no chest pain, palpitations, sweating h/o giddiness on and off, decrease...