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25.C.Ruchitha Reddy General Medicine Case 1;  August 16 2021. "This is an 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 problems with collective current best evidence based inputs.This e- log book also reflects my patient centered online learning  portfolio band your valuable inputs on comment box is welcome." Date of Admission:31/07/2021 A 65 years Old Female ,Who was a Agricultural labour ,Who was an occasional Alcoholic came to the casuality  with the cheif complaints of  - STOMACH ACHE,VOMITING since 20 days. HISTORY OF PRESENT ILLNESSES: Based on the information given by the patient,She was apparently asymptomatic 20 days before. Their was a suddenly onset of the stomachpain,vomiting 20 days back. Vomiting w...