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44 yr old male patient complaints of pedal edema since 10 days and decreased urine output since 5 days

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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 inputs. This e-log book also reflects my patient centered online learning portfolio and your valuable inputs on comment box is welcome. Chief complaints: A 44year man who is a farmer by occupation came to OPD with chief complaints of: 1)B/L pitting type of pedal edema since 10 days and decreased urine output since 5 days 2)pain in the abdomen since 4 days 3)vomiting since a day. History of presenting illness: He was apparently asymptomatic 1 and 1/2 yrs back , then he developed  swelling in face and lower limbs and visited doctor , and was on medication . He stopped medication after 10 days. After few days he had difficulty in