RESUMO
Background: The healthcare system in Lebanon faced unprecedented challenges following the COVID-19 pandemic and the devastating beirut blast on August 4th, 2020. The aftermath highlighted the system's vulnerability, corruption, and incapacity to provide essential services, leading to an urgent need for leadership transformation within primary healthcare centers (PHCs).Methods: This qualitative cross-sectional study assessed the quantum leadership skills of nurses in 30 PHCs within a 5-kilometer radius of the blast site. Data were collected six months post-blast using a self-administered questionnaire based on a binary outcome scale of agreement and disagreement, analyzed with IBM SPSS-19 software to evaluate the potential for leadership improvement.Results: The findings indicate a significant correlation between quantum leadership skills and the operational effectiveness of PHCs, particularly those managed by the Ministry of Public Health, which exhibited superior quantum leadership skills compared to others.Conclusions: The study underscores the necessity for a new leadership paradigm rooted in quantum theory to navigate the healthcare system through crises effectively. A quantum leader, characterized by heightened organizational consciousness and energy, is pivotal for ensuring a seamless transition towards recovery and resilience, ultimately fostering a breakthrough in the face of systemic breakdowns.
RESUMO
Background: The management of breech presentations represents a significant challenge in obstetrics, necessitating advanced skills for optimal clinical outcomes. Simulation-based training has emerged as a promising approach to enhance the proficiency of healthcare professionals in assisted vaginal breech deliveries, potentially improving neonatal outcomes.Methods: This research study was conducted at Rafic Hariri University Hospital, Beirut, to evaluate the impact of simulation-based training on the management of breech presentations. Using Robson’s classification, a comparative analysis was performed on the outcomes of breech deliveries before and after the implementation of this training. The focus was primarily on assisted vaginal deliveries within the R6 (all nulliparous women with a single breech baby, cesarean section) and R7 (all multiparous women with a single breech baby, cesarean section) groups.Results: Post-training, there was a notable increase in the rate of assisted vaginal deliveries in the R6 category, indicating the effectiveness of the simulation-based training. However, the rate of assisted vaginal deliveries within the R7 group showed no significant change. Additionally, the positive impact of the training demonstrated a time-sensitive decline, underscoring the necessity for ongoing practice and reinforcement of skills.Conclusions: Simulation-based training offers substantial benefits in managing breech presentations, particularly evident in the increased rate of assisted vaginal deliveries among nulliparous women (R6). However, the absence of change in the multiparous women (R7) group and the time-sensitive reduction in training effectiveness highlight the critical need for continuous skill development and reinforcement.
RESUMO
The intrauterine device (IUD) is a contraceptive method which are tiny, T-shaped plastic, that is placed within the uterus and left there, is used all throughout the world with more than 99% effectiveness rate. Pregnancy with a levonorgestrel-releasing intrauterine system (LNG-IUS) in situ is very rare. Intracavitary pregnancy with an IUD can lead to a higher risk of infection and preterm birth. We described a case of a live birth with an IUD inserted into the placenta. A 27-year-old Syrian woman in G4P3 with a history of healthy vaginal deliveries arrived in our delivery room at 39+3 weeks gestation complaining of labor pain A vaginal examination revealed bulging membranes and a fully dilated cervix. She delivered a live baby boy, weighing 3100 g and being sent to the nursery with an APGAR score of 9 to 10. When the placenta was examined, a white foreign object that was embedded there was discovered to be an intrauterine device. Although intrauterine pregnancy is a potential problem that must be taken into account, ectopic pregnancy is a reasonably common complication of intrauterine contraceptive devices. Although several studies have shown that term pregnancies with excellent prognoses can occur after the removal of intrauterine devices, close monitoring is necessary to detect misplaced copper-T and prevent undesired births.