86 year male born in a middle class family of 7 children, was an elder son, did not go to school and took upon family responsibility at a very young age and started fish business. He used to travel often inter country for his business. Can speak Hindi and Telugu. Childhood was pleasant, married at young age and had five sons. His parents expired due to old age. Patient started consuming alcohol (beer) during travelling occasionally and also started smoking. 16 years ago patient had complains of lower back pain and decreased urine output, went to Kamineni Hyderabad and was diagnosed as renal calculi and operated for same. Two years later he returned home from work, had dinner and went to bed. Early in the morning he felt tiredness and struggled to wake up, later he observed he had right upper and lower limb weakness and slurring of speech. Patient went to local hospital and was diagnosed as right hemiparesis . At the same time he was also diagnosed with hypertension and diabetes. A