Can I start fasting based on the moon sighting of another country?
You must follow the moon sighting of the country you are in.
Is it permissible to give multiple mudds (portions) of fidyah to a single person?
Yes, it is permissible to give multiple mudd of fidyah to a single person, because each day of fasting is considered an independent act of worship.
Does undergoing an endoscopy during the day in Ramadan affect the validity of fasting?
Undergoing an endoscopic procedure during the day in Ramadan—whether through the mouth, nose, front private part, or back private part—invalidates the fast.
Whoever undergoes such a procedure must refrain from eating and drinking for the rest of the day out of respect for the sacred month and make up for that day after Ramadan.
What is the ruling on using toothpaste during the day in Ramadan?
Using toothpaste does not break the fast as long as nothing reaches the body cavity. However, it is disliked (makruh).
It is preferable for a fasting person to use it before the time of fast starts or after Iftar (breaking the fast) to avoid risking their fast.