1. Abstract
In the last decade, heterotopic pregnancy incidence rised with the increased prevalence of ovulation induction and assisted reproductive technologies. In the first trimester, unrecognized heterotopic pregnancy can cause a life-threatening emergency. In this report, we describe a case of Heterotopic pregnancy and it’s management

1. Abstract
Onodi cell mucoceles are rare entities that can cause devastating ocular complications if not treated promptly. devastating ocular complications if not treated promptly. Diagnosis may be delayed due to the wide range of differential diagnoses of unilateral retrobulbar optic neuropathy. We give a thorough assessment of the literature on this entity and describe a novel instance of Onodi cell mucocele in a 39-year-old woman. To the best of our knowledge,
no prior review has been published on Onodi cell mucoceles. According to our research, following surgical decompression, 69% of patients with an Onodi cell mucocele reported improved vision. The great majority of these patients had endoscopic decompression; there was no discernible difference in the visual outcomes depending on when the surgery was performed. We describe here the case of a 61-year-old patient who had already undergone surgery for mucocele 12 years ago and who presented with permanent chronic nasal obstruction with no associated ophthalmological signs, revealing mucocele of the onodi cell.

1. Abstract
This study presents a case report demonstrating an anomalous
origin of the right subclavian artery from the aortic arch, accompanied by proximal dilation and a retro-esophageal course, characteristic of arteria lusoria and Kommerell’s diverticulum. The
research highlights the clinical significance of this anomaly and
discusses its management strategies, emphasizing the importance
of precise surgical intervention in addressing this condition.

1. Abstract
Esophageal Foreign Bodies (FBs) are the common clinical emergency, accounting for 4% of emergency endoscopic diagnosis and therapeutic approach. Approaches to handle these cases are evolved continuously and offered better treatment with less cost, reduced surgery, improved visualization with high success rate. Clinically data
are lacking to choose the better method and whether to use auxiliary devices or not, for safe, quickly, and efficiently with reduced complications to remove the esophageal FBs. In China only 20,000 cases of
adult esophageal FBs have been reported yet in the past five years.
However, up to date no retrospective studies have been evaluated the safe and effective endoscopic management of esophageal FBs in China.

1. Abstract
1.1. Background: Intestinal endometriosis (IE) is a chronic estrogen-dependent disease characterized by endometrial stroma outside the uterine cavity. It affects 10 to 15% of women and may present with pelvic pain and worsening quality of life. Treatment can be surgical, such as videolaparoscopic segmental colectomy (VSC).

1. Abstract
Irritable bowel syndrome (IBS) is a common chronic functional gastrointestinal disorder with a high prevalence rate, which affects the quality of life (QOL) and psychological health of patients to varying degrees. To understand the perceptions, attitudes, and treatment intentions of IBS among the general public, we conducted a questionnaire survey on IBS.

1. Abstract
Claudin-1 is an important member of the cellular tight junction protein, which is very important to barrier function. But some studies have shown that Claudin-1 is associated with cell proliferation, so its role in asthma gets more and more attention. Asthma is associated with clotting system in the lungs. Thrombin is thought to be associated with pro-inflammatory, pro-proliferative and pro-migratory activities. Also, thrombin can result in the disintegration of Claudin-1 from the tight junction protein complex. Therefore, we speculated that thrombin may interact with Claudin-1 in the lung tissue of asthma. Thirty female mice were randomly divided into 3 groups: normal control group, asthma group, thrombin group. The expression of claudin-1 was observed by immunofluorescence and RT-PCR.

1. Abstract
1.1. Case Report: We present a thirty year old female who was diagnosed recently to be suffering from cryptogenic related compensated chronic liver disease. She had no history of ascites, pedal edema, upper or lower gastrointestinal bleed or Porto systemic encephalopathy. On evaluation her complete haemogram revealed mild anemia and thrombocytopenia, liver function were mildly deranged with slight increase in serum bilirubin, transaminases and mild coagulopathy as evidenced by International Normalized Ratio (INR) level of 1.3. The renal function test, thyroid profile, blood sugar, serum electrolytes, autoimmune and Wilson profile were normal and viral screen was negative. The ultrasonogram abdomen revealed coarse and shrunken liver with altered echotexture and splenomegaly. The serum IgA TTG (tissue tranglutaminase) antibody test was positive (28.5 I.U./ml ). The patient was subjected to upper gastrointestinal endoscopy for screening of varices as well as duodenal biopsies for confirming associated celiac disease. The endoscopy revealed low grade esophageal varices but three prominent duodenal varices located in second part. Normally, duodenal biopsies for confirming celiac disease are also taken from second part of duodenum. In this case a great caution was taken while taking biopsy, so as to avoid trauma to duodenal varices. In such cases even biopsies from first part of duodenum can also be taken.

1. Abstract
1.1. Background and Aims: This study analyzed medications among NAFLD (controlled attenuation parameter ≥302 dB/m) ± diabetes or advanced fibrosis (AF, stiffness ≥9.7 kPa).
1.2. Method: 2017-2018 NHANES data were analyzed. Exclusion criteria were age<18, high alcohol consumption (≥7/14 drinks/week for females/males, respectively), or viral hepatitis.
1.3. Results: Of 3,899, 26.3% had NAFLD, 4.8% AF, 16.7% diabetes. Increased medications and classes were associated with NAFLD and AF. Diabetics had low usage of GLP1 agonists and SGLT2 inhibitors regardless of NAFLD status.
1.4. Conclusion: Individuals with NAFLD or AF had higher risk of polypharmacy, but decreased usage of potentially beneficial medications including GLP1 agonists and SGLT2 inhibitors.