<s>[INST] I have a new patient who returned from Pakistan 6 months ago with cough and was reportedly treated in hospital for 3 days. Pt still complaining of chest discomfort at lower 1/2 of sternum that radiates through to back , cough but no fever or phlegm. No other family members sick and smoking hx. Trying to get hospital records and sending for CXR. WBC 11.1, lymphs (abs) 3.4 and ESR 34. Thoughts? [/INST] Hello dear, thanks for your question on Chat Doctor. In my opinion your friend should get done 1. Chest x-ray to rule out lung infection. As chest pain can be due to infection.2. Another possibility is HERD (gastroesophageal reflux disease). In this because of laxity of lower esophageal sphincter, acid of the stomach tends to come up in the esophagus and cause discomfort in center of the chest. So TRT to follow these for better symptomatic relief.1. Avoid hot and spicy food.2. Avoid stress and anxiety.3. Avoid large meals, instead take frequent small meals.4. Start proton pump inhibitor.5. Go for walk after meals. </s>