This is an a 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. This E blog also reflects my patient online learning portfolio and your valuable inputs on the comment box is welcome. The patient/ attender was informed the purpose of the information being acquired. An informed consent was taken from patient. CHIEF COMPLAINTS: A 22 year old woman who is a farmer by occupation , resident of Nalgonda came to the medicine OPD with the chief complaints of : Facial puffiness since 5 months Bilateral pedal edema since 5 months Fatigue since 5 months HOPI : Patient was apparently asymptomatic 5 months back then she developed facial puffiness which is insidious in onset and gradually pr