39 yr old male cab driver by occupation resident of west bengal came to opd with chief complaint of 1.Abdominal distension since 2 months 2.Bilateral pedal edema since 2 months 3.decreased appetite since 2 months 4.decreased urine output since 1 month HOPI: Patient was apparently asymptomatic 2 months back then he developed abdominal distension which is insidious in onset gradually progressive associated with decreased appetite since then.In the same month he observed bilateral pedal edema upto knees which is of pitting type which increased on walking relieved with rest.after 1 month he observed decrease in urine output which is insidious in onset and gradually progressive No h/o fever, cough, breathlessness Past history: Not a k/c/o DM,Asthma,TB, Epilepsy, Thyroid disorders ,HTN,CKD,CVA,CAD Personal history: Diet :Mixed Appetite : normal Sleep: adequate Bowel and bladder movements: regular Occassional Alcoholic (180ml weekly once) - stopped 1 yr back Smokes Beedi 1pack/day --stop