It 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 box. A 60 YR OLD MALE CAME WITH C/O ABDOMEN DISTENSION SINCE 20-30 DAYS, PAIN ABDOMEN SINCE 1 WEEK, CONSTIPATION SINCE 2 DAYS, DECREASED URINE OUTPUT SINCE 2 DAYS PATIENT WAS APPARENTLY NORMAL 1 MONTH BACK THEN HE DEVELOPED ABDOMINAL DISTENSION WHICH IS PROGRESSIVE AND ASSOCIATED WITH PAIN ABDOMEN SINCE 1 WEEK, CONSTIPATION ANS DECREASED URINE OUTPUT SINCE 2 DAYS NOT A K/C/O HTN,DM,CAD,ASTHMA,TB H/O TRAUMA TO LEFT LEG 5 YR BACK OCCASIONALLY TAKES ALCOHOL GUTKA CHEWER NON SMOKER HIS APPE