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Serum sickness‐like reaction is a rare immunological condition which may develop following exposure to certain drugs such as penicillins, cephalosporins, and trimethoprim‐sulfamethoxazole, among many others. It is described classically as a type III hypersensitivity response to heterologous proteins. Its true mechanism is still unclear. We present a case of serum sickness‐like reaction to clarithromycin, a commonly prescribed drug for the treatment of respiratory tract infections. The patient had been taking this drug for 3 days when she experienced generalized body aches, rash, arthralgia, and shortness of breath, prompting presentation to the emergency department. Laboratory studies showed decreased C4 and total complement with a slightly elevated sedimentation rate. After exclusion of other possible causes, the diagnosis of serum sickness‐like reaction was made. The patient responded well to nonsteroidal antiinflammatory medication, antihistamines, and a short, tapering dose of steroids. To our knowledge, serum sickness‐like reaction to clarithromycin has never been reported previously. This case emphasizes the need for increased clinical awareness of such an adverse outcome to clarithromycin use. Journal of Hospital Medicine 2011. © 2011 Society of Hospital Medicine.

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The plants Cassia fistula and Terminalia arjuna are medicinally important and produce leaves and colourful blossoms that belong to the Caesalpinioideae of the legume family and the family of Combretaceae. The antioxidant, hydrogen peroxide, and phytochemical assessment (qualitative and quantitative) of methanolic and ethanolic extracts of Cassia fistula and Terminalia arjuna flowers and leaves were investigated in this work. In qualitative phytochemical evaluation, the presence of ten different chemicals of varying degrees and classes was observed, and alkaloids, steroids, tannis, glycosides, saponins, flavonoids, and terpinoids were confirmed during qualitative screening. During quantitative analysis, the Cassia fistula L. leaves showed the highest TFC (32.783A ± 0.073) and the TPC was observed highest in Terminalia arjuna flowers (42.800A ± 0.028). The highest DPPH percentage was recorded in C. fistula flowers (21.825A ± 0.069) compared to its lowest value observed in C. fistula leaves (10.660B ± 0.053). The highest hydrogen peroxide (H2O2) scavenging activity among both plants was found in C. fistula (12.526A ± 0.146) and the lowest in its leaves (7.1470B ± 0.045). The methanolic extracts showed promising antioxidant activity. The presence of bioactive components in the leaves and flowers of Terminalia arjuna and Cassia fistula suggests that these flowers and leaves might be used as a phytochemical source and are also effective and safe as natural remedies. The biochemical analysis proved that the extracts of Cassia fistula and Terminalia arjuna plants have glycosides, flavonoids, and alkaloids that play a role in antioxidant activity.