A 56 year old male came to the OPD with complaints of abdominal distension from 2 days CHIEF COMPLAINT : Swelling of abdomen since 2 days HISTORY OF PRESENT ILLNESS: Patient was apparently asymptomatic 2 and half months back ,then he developed pedal edema -pitting type grade 1 then gradually progressed to grade 2 over 10 days to grade 3 over 15 days He first developed left lower limb swelling extending upto his ankle and he later gradually developed swelling of his right lower limb and the swelling in both his lower limbs extended upto his thighs no complaints of fever, cough, burning micturation, loose stools, vomiting No complaints of dyspnea, hematuria, frothy urine, no complaints of Chest pain, palpitations, orthopnea, PND HISTORY OF PAST ILLNESS : H/o pulmonary koch's 22 yrs back ,used ATT for 6 months HTN since 2 months PERSONAL HISTORY: Married Appetite-decreased Regular bowel and bladder movements Occasionally alcoholic GENERAL EXAMINATION : Patient is conscious, coher