Background and aim Hydroxyurea (HU) plays an essential role in the complex pathophysiology alteration of sickle‐cell disease (SCD), which translates clinically into the enhanced quality of life and increased survival. This research examines adult patients with SCD's attitudes and awareness toward HU, as well as underutilization consequences. Method A cross‐sectional research was performed in Saudi Arabia, and adult patients with SCD were interviewed. The survey includes patient demographics, attitudes, and knowledge of HU and clinical data. The chi‐square was applied through SPSS version 23 for assessing any association with outcome variables and demographic characteristics. Results HU is known to 72 (67.3%) of the 107 patients. The hydroxyurea treatment was initiated in 46 patients (63%). Of these, 23 (50%) discontinue HU, with the key factors being pregnancy preparation and side effects development. For those who were unaware of HU, 13 (37.1%) were admitted to the intensive care unit because of acute chest syndrome, 29 (82.8%) required a frequent blood transfusion and 12 (34.2%) with frequent hospitalizations. However, there was no significant relationship between awareness and education level (P value is .078 > .05). In addition, there was no significant relationship between the level of awareness and age and gender of participants (P value is .68 and .44, respectively). Conclusion HU is a long‐established and effective disease‐modifying agent for SCD patients, but it is underutilized. The causality of underuse is bidirectional between patients and healthcare providers. It is essential to educate healthcare providers and patients with SCD about hydroxyurea role in modifying disease severity, resolving adverse events, and achieving full benefits.

COVID-19 is a severe respiratory disease with a spectrum of clinical presentations and complications. Warm autoimmune hemolytic anemia (WAIHA) is increasingly recognized in patients with COVID-19 either while infected or shortly after infection. We report a 36-year-old male with clinical and laboratory findings consistent with WAIHA. His medical history was significant for COVİD-19 infection three months before presentation. He was initially resistant to steroids but had substantial improvement following initiation of rituximab, with complete recovery thereafter. Therefore, serial assessment of complete blood cell count parameters and hemolysis markers post-COVID-19 infections is warranted for early detection and prompt treatment.

Background and Aims Thrombocytopenia is increasingly recognized among patients with critical illness and plays a role in several diseases affecting different organ systems. Therefore, we studied the prevalence of thrombocytopenia among hospitalized COVID‐19 patients and its correlation with disease severity and clinical outcomes. Methods This was an observational retrospective cohort study conducted on 256 hospitalized COVID‐19 patients. Thrombocytopenia is defined as a platelet count below 150,000/μL. Disease severity was classified based on the five‐point CXR scoring tool. Results Thrombocytopenia was found in 66 (25.78%) patients. In outcomes, 41 (16%) patients were admitted to intensive care unit, 51 (19.9%) died, and 50 (19.5%) had acute kidney injury (AKI). Of the total patients with thrombocytopenia, 58 (87.9%) had early thrombocytopenia, while 8 (12.1%) had late thrombocytopenia. Notably, mean survival time was markedly decreased in late‐onset thrombocytopenia cases ( p < 0.0001). Patients with thrombocytopenia showed a significant increase in creatinine compared to those with normal platelet counts ( p < 0.05). Moreover, thrombocytopenia was more prevalent in patients with chronic kidney disease compared to other comorbidities ( p < 0.05). In addition, hemoglobin was significantly lower in the thrombocytopenia group ( p < 0.05). Conclusion Thrombocytopenia is a common finding among COVID‐19 patients, with a predilection toward a specific group of patients, though the exact reasons are unclear. It predicts poor clinical outcomes and is closely linked to mortality, AKI, and the need for mechanical ventilation. These findings suggest that more research is required to study the mechanism of thrombocytopenia and the possibility of thrombotic microangiopathy in COVID‐19 patients.

Primary myelofibrosis and paroxysmal nocturnal haemoglobinuria (PNH) are uncommon clonal blood disorders that are rarely found together. We report a case of primary myelofibrosis (PMF) with concomitant subtle PNH in a 42-year-old man who presented with a 4-week history of fatigue, unexplained chest pain, and new-onset erectile dysfunction. Bone marrow biopsy showed severe fibrosis consistent with PMF. However, smooth muscle dystonia symptoms in the form of new-onset erectile dysfunction and oesophageal spasm were not fully explained by PMF but were clues for PNH, confirmed by flow cytometric assays. Routine PNH testing for patients with new-onset PMF and clinical symptoms suggestive of PNH, as well as those with refractory anaemia despite effective therapy, is crucial since these two conditions can coexist. As a result, a lack of early testing may cause a delay in diagnosis, increasing the patient’s transfusion load and the facility’s costs.

Background Heavy menstrual bleeding (HMB) is a common clinical problem. However, seeking medical advice might be delayed until patients develop several clinical consequences. Aim To assess the prevalence and awareness of HMB among the Saudi female population and measures that are commonly used to control the bleeding. Method This is a cross‐sectional study where a trained study team member carried out a survey. The survey includes patient demographics and medications history, comorbidities, blood transfusion, and patient perception about her period. HMB was defined as bleeding lasting >7 days, flooding or changing protection more than every 2 hours, and passing clots >1 in. in diameter. Results Four hundred and thirty‐one women were evaluated for HMB with a median age of 27.72 ± 7.75. Out of the total number, 281 (65.2%) females were identified to have HMB. Among these 281 females, only 35.6% were aware of having HMB, whereas 64.4% either unaware or unsure about having it. For those who were aware of having HMB, only 32% seek medical advice, particularly gynecology clinic though 46.6% were not satisfied with offered management. On the other hand, 28% and 3.9% of those unaware of having HMB did required iron supplementation and blood transfusion, respectively. Conclusion HMB is a major clinical problem though awareness about having HMB lacks regardless of the age and education level. Raising awareness and a multidisciplinary approach may result in early diagnosis, early intervention, and reduction of clinical consequences.