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  This is an E log book to discuss our patient de- identified health data shared after taking his/her consent  A  51  year old male patient resident of Miryalguda , farmer by occupation ,presented with a chief complaint of   1.  Fever    since 10    days 2.  Cough   with  sputum  since  10  days   3.  Shortness of breath  since 7 days  History of present illness Patient was apparently  asymptomatic   10 days back then developed following symptoms   Fever -   insidious in onset and it was associated with chills and rigors with diurnal variation which was more during the night , Relieved on medication  Then he developed  Expectorate   Cough  which  gradually progressed more during the nights followed a similar  diurnal pattern . It aggrevated  during exposure to colder climates .The sputum was scanty and yellow which was non foul smelling Cough was associated with  Chest pain   which was non radiating in nature and  aggrevated on lying down  relieved on sitting upright  He later devel

  This is an online e logbook to discuss our patients deidentified health data shared after taking her/guardian's signed informed consent Here we discuss our individual patient 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 inputs This E log also reflects my patient centre’s online learning portfolio and valuable inputs on the comment box is welcome. Case - A 45 year old gentlemen ,from ramanapet who is farmer by occupation came to the OPD with CHIEF COMPLAINTS: Bilateral Pedal edema since 3 months  Shortness of breath (SOB) since 3 months HISTORY OF PRESENT ILLNESS: Patient was apparently asymptomatic 3 months back then developed  pedal edema, Insidious in onset, Bilateral ,gradually progressive from involving ankles to limbs  (grade1to grade 3 ), pitting type  Aggravated   by walking and by end of the day, Relieved by elevating leg,  Then deve