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This 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 reflects my patient centered online portfolio and your valuable inputs on the comments is welcome.” A 61 year old male resident of Ramulapeta,yadadri dist who is a daily wage labourer in construction work came to the hospital with complaint of CHIEF COMPLAINTS Dry cough since 10 days  Dragging pain towards the finger tips since 10 days Lower back pain since 10 days Shortness of breath Grade 2 -grade 3 Chest pain near heart since 10 days   HISTORY OF PRESENTING ILLNESS PATIENT WAS APPARENTLY ASYMPTOMATIC 3 YEAR AGO WHEN  He noticed involuntary movements of upper right limb at rest and de...
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