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Accurate determination of ER, PR and Her2/neu status in primary IDC breast is important to guide further treatment. Change in receptor status post NAC may warrant corresponding change in hormonal therapy.

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INTRODUCTION: High-resolution esophageal manometry (HREM) is a technique to determine the pressure pattern which is a function of esophageal musculature and integrity of LES. The indications for HREM evaluation include evaluation of nonobstructive dysphagia, symptoms of regurgitation and noncardiac or atypical chest pain unexplained by endoscopic evaluation To analyse profile of esophageal motility disorders in patient presenting with refractoryAIM: gastroesophageal reflux disease (GERD), dysphagia and atypical chest pain in tertiary care centre in Western India METHODS: We enrolled patient presented with refractory GERD, dysphagia and atypical chest pain from Jan 2020 to March 2022 at Department of gastroenterology, National Institute of Medical College & R, Jaipur. Upper GI endoscopy and high-resolution esophageal manometry was done in all patients Ineffective esophageal peristalsis,RESULTS: achalasia cardia, hypercontractile esophagus, fragmented peristalsis and esophagogastric junction outflow obstruction were common diagnosis made by high resolution esophageal manometry In our study ineffectiveConclusion: esophageal motility most common and achalasia cardia second most common diagnosis identified on esophageal manometry

Background: Background: Celiac diseases are found to be associated with other autoimmune diseases such as autoimmune thyroiditis, type I diabetes, Addison’s disease, primary biliary cirrhosis, and inflammatory bowel disease (IBD). In literature, only a few cases were described simultaneously presenting both conditions in the same patient. Case Presentation:: A 23-year-old Indian male presented with a one-month history of loose motion 10-12 times per day, having watery stool, and nocturnal diarrhea. The patient had pallor, weakness, fatigability, and anorexia/weight loss. The patient also had a history of periumbilical pain abdomen and black-colored stools. In our study, both conditions are clinically symptomatic in the same patient, as proved by endoscopic changes and histopathologically. Esophagogastroduodenoscopy (EGD) examination shows severe scalloping of duodenal folds and nodularity, indicating celiac disease changes. A colonoscopy examination was performed, which revealed multiple linear longitudinal ulcerations, friability, erosions and absent vascularity, which indicates Crohn’s disease. Duodenal biopsy shows celiac disease (Marsh IIIa), and Colonic biopsy shows Crohn’s disease. The patient was treated with improvement in abdominal pain, weight, and anemia. Conclusion: Celiac and Crohn’s both conditions are clinically symptomatic in the same patient, as proved by endoscopic and histopathological changes.