This is an online e log book to discuss our patient de-identified health data shared after taking his / her / guardians signed informed consent. Here we discuss our individual patients problems through series of inputs from available global online community of experts with an aim to solve those patients clinical problem with collective current best evident based input. CHIEF COMPLAINT: A 70 year old male patient resident of annaram ,who is farmer by occupation presented to the opd with chief complaints of pedal edema ,sob , and generalized weakness since 20 days. HISTORY OF PRESENT ILLNESS Patient is apparently asymptomatic 3 months back then he developed sob which gradually progressed from grade II to grade III . This was associated with pedal edema which is pitting type up to the knee and not associated with chest pain and palpitations. Patient has history of fever and chills (on and off) since 2 months. Patient has no facial puffiness and no decrease in urine output. Patient ha