Institutional Board Research Articles

Prognostic implications and therapeutic response in GNAS-mutated colorectal adenocarcinoma: A retrospective cohort analysis.

244 Background: GNAS, a key regulator of the G-protein signaling pathway, is frequently mutated in colorectal adenocarcinomas and other malignancies. Despite its role in tumorigenesis, GNAS mutations remain understudied, with no established targeted therapies. Exploring the impact of GNAS alterations on therapeutic response and outcomes in colorectal cancer (CRC) is crucial for developing effective treatment strategies. Methods: We reviewed 531 CRC cases from our institutional Molecular Tumor Board database, identifying 8 patients with GNAS mutations. The prevalence ofGNASmutations in our cohort was 1.5%, which aligns with reported rates of 2-5% in various CRC cohorts. Comprehensive clinicopathologic data, including tumor histology, staging, treatment outcomes, and response rates, were analyzed. A detailed evaluation was conducted on stage IV patients to assess their response, progression-free survival (PFS), and overall survival (OS) in comparison to historical stage IV CRC benchmarks. Results: The cohort included 8 patients with a median age of 61 years (range: 33-73 years), with balanced gender representation (50% male, 50% female). The racial distribution was 50% Black or African American, 25% White, and 12.5% Asian or Pacific Islander. The majority of patients (62.5%) were diagnosed at stage IV, with primary tumor sites predominantly in the sigmoid colon and cecum. Among the 5 stage IV patients, while no patients achieved a complete or partial response, 3 exhibited stable disease, resulting in a 60% disease control rate (including stable disease). The median progression-free survival (mPFS) was 9 months, reflecting the duration of disease control before progression, while the median overall survival (mOS) was 15 months. These outcomes are notably lower than historical benchmarks for stage IV CRC, where response rates typically range from 40-50% with mOS of 20-24 months, highlighting the potentially adverse prognostic impact of GNAS mutations. Conclusions: Patients with GNAS-mutated colorectal adenocarcinoma appear to represent a unique subset with poorer therapeutic outcomes, even when achieving stable disease. The observed disease control in the absence of objective responses underscores the complexity of treating GNAS-mutated tumors and highlights the urgent need for targeted therapies tailored to this molecular subtype. Further research into the biological mechanisms underlying GNAS mutations and their impact on CRC treatment resistance is warranted to improve patient outcomes.

Translation, cultural adaptation and validation of the Achilles Tendon Total Rupture Score (ATRS) into Spanish: a study protocol

The Achilles tendon is the strongest and largest tendon in the human body, yet it is also the most frequently ruptured. The incidence of Achilles tendon rupture (ATR) is increasing...

Institutional Ownership, Board Diversity, And Carbon Emission Disclosure

Global warming is a crucial issue that is being discussed today. One of the causes of global warming is the development of the industrial sector, which contributes to greenhouse gas emissions. This condition requires public companies to disclose carbon emissions. This study explores the role of institutional ownership and board diversity in carbon emission disclosure (CED) in Indonesia. Board diversity refers to the female and foreign director variables. The study was conducted on manufacturing companies over three years and data analysis using moderated regression analysis. The study results revealed that institutional ownership increased CED. Nevertheless, board diversity testing as a moderation variable provides inconsistent results. The results of the interaction test revealed that the existence of female directors was able to moderate the relationship between institutional ownership and CED. Conversely, foreign directors cannot moderate the relationship between institutional ownership and CED.

The effect of financial constraints on strategic alliances: agency perspective versus resource dependence perspective

PurposeThis study examines the effect of financial constraints on firms’ decision to form strategic alliances as a choice of growth strategies. Drawing on agency theory, we argue that financially constrained firms engage in strategic alliances to a greater extent due to the disciplinary role of financial constraints. Nevertheless, financially constrained firms may use strategic alliances as a means to gather more resources from alliance partners. Thus, we further examine agency perspective versus resource dependence perspective through institutional ownership and board size as boundary conditions respectively.Design/methodology/approachWe test our hypotheses on a sample of all publicly traded industrial U.S. firms covering the years 1985–2017 that engaged in strategic alliances.FindingsWe find that financially constrained firms increase strategic alliances. Moreover, high institutional ownership acts as the monitoring mechanism, which weakens the positive association between financial constraints and strategic alliances.Originality/valueThis study provides a better understanding on financially constrained firms’ decision to form strategic alliances by examining the monitoring role of institutional investors and the resource provision role of the board of directors.

Safety and Effectiveness of Yttrium-90 Radioembolization in People Living with HIV.

To investigate if Yttrium-90 radioembolization (Y90 TARE) is a safe and effective treatment in people living with HIV (PLWH) with hepatocellular carcinoma (HCC) across the BCLC stage spectrum. A retrospective review was conducted of all patients with HCC presented at a multidisciplinary institutional liver tumor board who underwent Y90 TARE between January 2014 and June 2023. Thirty-nine patients with documented HIV seropositivity prior to Y90 TARE and adherence to HAART were included. For 19 (48.7%) patients, CD4 and total lymphocyte counts and HIV viral load PCR data were collected before and after Y90 TARE within 12 weeks of therapy. Kaplan-Meier analysis was used to compute median overall survival (OS) and the Fine-Gray sub-distribution hazard model was used to estimate progression-free survival (PFS). Imaging response was assessed by mRECIST and adverse events were analyzed per CTCAE version 5.0. For the 19 patients with HIV laboratory data available, the mean CD4 lymphocyte count dropped from 374.3 +/- 238.9 cells/mm3 to 180.3 +/- 144.3 cells/mm3 (p<0.001) after Y90 TARE but rebounded to 320.9 +/- 234.3 cells/mm3 at 12-month follow up (p=0.01). The overall response rate (ORR) was 87.2% and the disease control rate (DCR) was 97.4%. Median OS was 35.8 months (95% CI 17.0 months to no estimate [NE]) and median PFS was 14.7 months (95% CI 10.7-28.9 months). There were no grade 3 clinical toxicities, 3 grade 3 biochemical toxicities and 1 opportunistic infection 18 months following Y90 TARE were reported. Y90 TARE is safe and effective in PLWH with HCC. No significant HIV-related adverse events were attributable to radioembolization.

The impact of targeted therapies on molecular alterations identified by an institutional molecular tumor board: an approach based on ESCAT classification

The impact of targeted therapies on molecular alterations identified by an institutional molecular tumor board: an approach based on ESCAT classification

Danish cohort study of tympanic membrane retractions and manifestations of Eustachian tube dysfunction

AbstractObjectivesOur objective is to evaluate the prevalence of tympanic membrane (TM) retractions and management of signs of Eustachian tube dysfunction (ETD) in both children and adults following type 1 tympanoplasty or myringoplasty. Furthermore, to identify potential risk factors for developing ETD and TM retractions.MethodsRetrospective cohort study of 423 patients (5–86 years of age) undergoing 452 procedures. We extracted data from electronic patient journals during scheduled consultations to calculate prevalences and relative risks. The project was reported to the Danish Data Protection Authority, and access to electronic patient journals was approved by the Institutional Board of Gødstrup Hospital.ResultsAt 1 year postoperative follow‐up, the prevalence of TM retractions was 12.7% and ETD manifestations without a concurrent TM retraction was 4.2%. The graft failure rate was 11.0%. Risk factors for developing TM retractions included preoperative myringosclerosis, history of ipsilateral ear surgery, posterior perforations, and use of perichondrium graft. Conversely, previous contralateral ear surgery and temporal fascia graft use were associated with decreased risk. ETD manifestations were significantly increased in cases of preoperative bilateral perforation, history of ipsilateral ventilation tube, and traumatic TM perforation.ConclusionsTM retractions accounted for 12.7%, ETD manifestations without a concurrent TM retraction 4.2%, and graft failure 11.0%. The dynamic nature of these complications necessitates diligent follow‐up strategies.Level of evidenceLevel 4.

Predicting chronic kidney disease progression in children with posterior urethral valves

ObjectivePosterior urethral valves (PUV) leads to early chronic kidney disease (CKD) and renal failure in some children, while others may maintain preserved kidney function even into adulthood. Our goal was to assess the association between early imaging features and CKD progression in children with PUVs. We hypothesized that imaging features identified on PRUS and VCUG would be associated with CKD progression and could` be used in conjunction with nadir creatinine to predict future renal function. MethodsFollowing individual institutional research board approvals, we performed a retrospective cohort study at two institutions. Electronic medical records were queried to identify all patients with a history of PUVs treated between 1990 and 2022. Children who presented in the first year of life and had their initial renal bladder ultrasound (RBUS) and voiding cystourethrogram (VCUG) performed within the first 90 days of life were included. The primary outcome, CKD progression, was defined as development of ESKD requiring dialysis or renal transplant or a decline in eGFR of greater than 50%. Clinical variables of interest included: findings on initial RBUS (urinoma, cystic dysplasia, solitary kidney), vesicoureteral reflux on initial postnatal VCUG (degree and laterality), and nadir creatinine. Hazard ratios (HRs) were calculated from Cox proportional hazards regression for univariate and multivariable regression. ResultsOut of 537 patients with PUVs, 274 met our inclusion criteria. Median follow up was 5.84 years (IQR 2-10.2), and 55 patients (20%) reached our primary outcome. Multivariable analysis showed the presence of any degree of vesicoureteral reflux, HR 3.1 (95% CI 1.62-5.93), and nadir creatinine, HR 5.53 (95% CI 4-7.64), were predictive of CKD progression When nadir creatinine within the first year of life is used as a sole predictor of CKD progression, the area under the receiver-operator curve was 0.89 (95% CI .83-.91). ConclusionsThis study confirms nadir creatinine as a strong predictor for CKD progression and ESKD in patients with PUVs. In our cohort, the presence of any degree or laterality of vesicoureteral reflux, was also a significant predictor for CKD progression.

“Dear John”: Overriding institutional axiology by privileging Indigenous relational ethics

Institutional ethical oversight of research involving humans conducted at Canadian universities is guided by the Tri-Council Policy Statement: Ethical Conduct for Research Involving Humans (TCPS2). Beginning in 2010, the TCPS2 included a chapter specific to research involving First Nations, Inuit, and Metis Peoples of Canada, which is intended to provide a framework for the ethical conduct of research with Indigenous communities. These institutional guidelines reflect progress in the way research is done with Indigenous communities. However, concerns remain about the ways in which these guidelines are taken up, interpreted, and operationalized by institutional research ethics boards, which include creating tensions and challenges for Indigenous scholars conducting research together with their own communities. The purpose of this paper is to describe some of the challenges and conflicting expectations we faced as an Indigenous doctoral student and non-Indigenous academic supervisor, navigating the axiological differences between institutional ethical oversight and community relational ethics with the aim of supporting other Indigenous scholars who may experience similar challenges and influencing policy change and relational engagement in ethical review processes in university settings. We outline the various critiques of institutional oversight of Indigenous research, share several examples of how we experienced the tensions and potential/actual harm that institutional power interference caused in the review process and how we worked through them, and demonstrate how, in our experience, it was not bureaucratic institutional procedures that protected community participants from risk, it was community relationships. We conclude by discussing implications and offering our suggestions for change.

PENGARUH CORPORATE SOCIAL RESPONSIBILITY, GOOD CORPORATE GOVERNANCE DAN DIVIDEND POLICY TERHADAP KINERJA PERBANKAN DI INDONESIA

This research aims to examine the influence of corporate social responsibility, good corporate governance (institutional ownership and board size), and dividend policy on the financial performance of banking in Indonesia Stock Exchange (IDX) during the period of 2018 to 2022. A sample of 44 was selected using purposive sampling. The analysis was conducted using E-Views, and the results indicate that corporate social responsibility, good corporate governance, and dividend policy simultaneously affect financial performance. CSR and GCG (institutional ownership and board size) do not significantly influence banking performance in Indonesia, while dividend policy has a significant negative effect on banking performance. This study provides insights for banks and investors to consider dividend policy in managing their businesses and making investment decisions.

The Influence of Audit Tenure, Audit Fee, and Institutional Ownership on Audit Delay: Study of Companies in Various Industrial Sectors Listed on The Indonesian Stock Exchange 2018-2022

ABSTRACT Purpose: This research aims to analyze the influence of audit tenure, audit fee, and institutional ownership on audit delay.Design/methodology: To do this research, the method chosen is quantitative. The sample used included 21 companies from various industries listed on the Indonesian Stock Exchange and data collected over five years, from 2018 to 2022. The logistic regression test is the analysis used.. Findings: The results showed that the probability values of audit tenure, audit fees, and institutional ownership were less than the significance level of 0.05, suggesting that the increase and decrease in the number of audits in tenure, audit fees, and institutional ownership were not large enough to indicate a significant influence on the audit delay proposed as a hypothesis.Practical implications: The author organized the diverse factors and findings inside the structured literature review, while this study, which focuses on Institutional Ownership and board governance, provides valuable insights into earlier studies. The writers guide academics, regulatory agencies, and company practices in this corporate governance topic.Originality/Value: This research is relatively new because it uses varying audit fees and various industrial sectors, which include various industrial sectors, so that the research results can be more acceptable.

Conception of a Recognized Accreditation for a Senior-Friendly Hospital: The Accreditation “Hospital Attentive to the Elder”

ObjectivesConsideration of the need to strengthen the commitment of professionals to the good care of the older population in hospitals has been emerging over the last several years. The steering committee of the geriatric sector of the hospitals of our Hospital Consortium (HC) has structured an accreditation project to promote the commitment of professionals to the good care of older adult patients in hospitals: the “Hospital Attentive to the Elder” (HAE) accreditation. This global approach aims to better adapt care to the needs of this population in the hospital and promote positive values (eg, kindness, attentive support). DesignThe creation of the HAE accreditation required the creation of an accreditation board, a referential framework, and an accreditation procedure. Setting and ParticipantsThe whole process was coordinated by the accreditation board, a multidisciplinary entity, representative of the hospitals of our HC. MethodsThe 5-step approach of the accreditation procedure includes a commitment to the HAE, with the support of the institutional board, and an internal self-assessment phase to guide the creation of action plans, followed by an accreditation cross-evaluation visit. The HAE accreditation is awarded to departments that meet the described criteria. This accreditation process was initially initiated by our HC. ResultsIn June 2021, 6 of 10 hospitals of our HC and 11 departments, which mobilized 28 medical, paramedical, and quality referents, initiated the process. All 11 departments fulfilled the criteria for the accreditation, and a ceremony to hand out the certificates was organized in December 2023. Conclusions and ImplicationsWe envisage that this accreditation process could be offered at the regional and national level to any hospital or group of hospitals with departments that receive patients aged >75 years, regardless of their specialty.

The Impact of Board Characteristics on the Financial Slack–CSR Relationship: Evidence From the Indian Hospitality and Tourism Industry

Extant research in the hospitality and tourism (H&amp;T) industry has largely ignored the influence of contextual factors like institutional environment and board characteristics on the financial slack and CSR relationship. Our study combines the institutional differences hypothesis, slack resource theory, and agency theory to provide a nuanced understanding of this relationship in the context of the H&amp;T industry in India. Using a panel of 464 firms from three H&amp;T sectors between 2011 and 2019, our analyses indicate a U-shaped relationship between financial slack and CSR intensity, and a positive moderating effect of board gender diversity and board independence. We show how resource-constrained H&amp;T firms in emerging markets with underdeveloped institutions deploy slack resources towards CSR and, rather than setting a minimum threshold, we posit that governmental policies should strengthen capital markets so that H&amp;T firms can voluntarily invest in strategic CSR. Further, strengthening board diversity policies enables H&amp;T firms to invest in CSR organically.

Clinical Utility of Molecular Tumor Board Review for Identification of Possible Germline Pathogenic Variants on Tumor Next-Generation Sequencing Reports.

Tumor next-generation sequencing (NGS) testing identifies possible germline pathogenic variants (PGPVs), creating a dilemma for appropriate recognition, triage, and management. The objective of this study was to determine the clinical utility of an institutional molecular tumor board (MTB) in assessing tumor NGS reports for PGPVs. Our institutional MTB reviews all NGS reports to provide treatment and further testing recommendations, including genetic counseling referral and consideration of genetic testing (GC/GT). We studied the patients reviewed by the MTB who were recommended for GC/GT to determine the frequency of referral to a GC, germline test completion, rate of pathogenic germline variants (PGVs), factors related to PGVs, and germline conversion rate (GCR). Of the 2,355 patients reviewed by the MTB during the study period, 609 (25.9%) had a recommendation for GC/GT. Of the 609 with a GC/GT recommendation, only 181 (29.7%) were referred for GC/GT by their treating physicians, and only 107 (17.6%) completed GT. Of the 107 patients completing GT, 29 (26%) had a confirmed PGV. The only factors significantly associated with PGVs were testing due to a PGPV and higher mean variant allele fraction on the tumor NGS. Only 40 patients with a GC/GT recommendation (14.3%) due to a PGPV completed GT; however, the GCR was 42.5% (n = 17/40). The MTB review of PGPV is clinically valuable, identifying PGPV in 12% of patients undergoing tumor NGS and a GCR of 42.5%. Rates of GC/GT completion were relatively low due to under-referral by treating physicians. Given the high GCR, the authors encourage institutional algorithms to help increase GC/GT rates for patients found to have PGPV following tumor NGS testing.

Vision preserving role of radiotherapy in orbital plasmablastic lymphoma

An uncommon but aggressive variant of diffuse large B-cell lymphoma is plasmablastic lymphoma (PBL). Although they primarily involve the gastrointestinal tract, lymph nodes, and oral mucosa of immunocompromised males, orbital presentation is rare. In this article, we report a case of an elderly, immunocompetent gentleman presenting with progressive proptosis, ptosis, and diminished vision of the right eye with a palpable mass in the right upper eyelid. Imaging and biopsy confirmed the rare diagnosis of orbital PBL. After obtaining institutional tumor board concurrence, the patient was delivered 45 Gy external beam radiation therapy followed by six cycles of chemotherapy. Post-therapy, he is in remission with improvement in vision and is currently on maintenance chemotherapy.

POLITICAL CONNECTIONS, CORPORATE GOVERNANCE AND INVESTMENT EFFICIENCY: EVIDENCE FROM MALAYSIAN FIRMS

This study investigates the moderating role of corporate governance in the relationship between political connections and investment efficiency. Using a sample of Malaysian publicly listed firms from 2001- 2017, we find that political connections are negatively correlated with firm investment efficiency. Moreover, the relationship is robust with the inclusion of corporate governance mechanisms, which moderated the potential consequences of agency problems in politically connected firms. The evidence suggests that corporate governance appears to be an effective mechanism to improve investment efficiency in politically connected firms. Consistent with the agency costs of free cash flow theory, we also discover that political connections have a more significant detrimental impact on overinvestment compared to their positive influence on underinvestment. Nevertheless, the interaction results in corporate governance hold regardless of overinvestment or underinvestment. Further analysis reveals that domestic institutional ownership, Big Four auditors, and audit committees are effective governance mechanisms, whereas similar observations do not hold for foreign institutional ownership, board size, board independence, and director ownership. Resultantly, high direct policy relevance is provided for governance practitioners and policymakers in monitoring the investment activities of PCFs.

Unmet supportive care needs among survivors of stroke in Australia: A cross-sectional study.

To examine, among survivors of stroke: (a) the prevalence of and most frequently reported unmet needs; and (b) the sociodemographic and clinical factors associated with higher counts of unmet needs. A cross-sectional study was undertaken with survivors of stroke recently discharged from eight hospitals in Australia, with institutional board approval. Survivors were mailed one survey for completion after their discharge from hospital. Unmet needs were measured by the Longer-Term Unmet Needs After Stroke (LUNS) tool. The number and percentage of participants who reported unmet needs were calculated. The association of sociodemographic factors, type of stroke, and thrombolysis treatment to total LUNS scores was examined using mixed ordinal logistic regression. A total of 402 survivors (35% of those approached) between April 2018 to December 2019 returned a completed survey. 83% reported at least one unmet need. The most frequently reported unmet need was needing more information about their stroke (n = 239, 61%). Those who identified as Aboriginal and/or Torres Strait Islander had approximately 5.6-fold higher odds (OR = 5.59, p = .025) of having more longer-term unmet needs compared to those who did not identify as Aboriginal and/or Torres Strait Islander. Unmet needs are common in recently discharged survivors of stroke. These findings may be used to inform strategies that support recovery. Providing more information may help reduce unmet needs among survivors of stroke. Enhanced hospital discharge planning and enhanced community services for survivors may help better prepare them and their caregivers for the return home. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Learning Preference of Health Care Professional Students at a Multi-culturalUniversity in the United Arab Emirates

Background: Identifying the preferred learning modalities of students is crucial for a comprehensive understanding of the content of the study, and this can be achieved by employing the VARK inventory developed by Neil D. Fleming. The preferred learning modality of students significantly influences their learning outcomes. Aim: This study aimed to identify the preferred learning modalities among health professional students. Methods: Using a cross-sectional survey study design, we surveyed a consecutive sample of 351 students from three health professional programs: Nursing, Medical, and Pharmacy. After obtaining institutional board approval, a standardized self-administered VARK inventory (Visual, Aural, Read/write, Kinaesthetic), version 7.8, was employed. VARK scores were computed for each respondent and sent to the publisher for interpretation and categorization of learning preferences. Data were analyzed using SPSS version 28.0 and 29.0. Results: The findings revealed that 35.9% of participants were between 18-20 years old and identified as unimodal learners, with 19.1% preferring kinaesthetic learning. In the bimodal and trimodal categories, 5.98% exhibited preferences for AK (Aural, Kinaesthetic) and VAK (Visual, Aural, and Kinaesthetic). Only seventy students (19.9%) preferred multimodal learning patterns. Notably, all the college students were identified as unimodal learners. Conclusion: Understanding these diverse learning preferences empowers students to employ appropriate learning methods, enhancing their overall learning experience. Faculty members can leverage this data to tailor teaching styles, thereby optimizing the learning environment. Further research across different universities can contribute to broader knowledge and informed strategies that promote effective learning processes.

Utilization of Texture Analysis in Differentiating Benign and Malignant Breast Masses: Comparison of Grayscale Ultrasound, Shear Wave Elastography, and Radiomic Features.

This study aims to determine which qualitative and quantitative US features are independently associated with malignancy, including those derived from grayscale imaging morphology, shear wave elastography (SWE), and texture analysis. This single-center retrospective study was approved by the institutional research ethics board. Consecutive breast US studies performed between January and December 2020 were included. Images were acquired using a Canon Aplio i800 US unit (Canon Medical Systems, Inc., CA) and i18LX5 wideband linear matrix transducer. Grayscale US features, SWE mean, and median elasticity were obtained. Single representative grayscale images were analyzed using dedicated software (LIFEx, version 6.30). First-order and gray-level co-occurrence matrix second-order texture features were extracted. Multivariate logistic regression was performed to assess for predictors of malignancy (STATA v16.1). One hundred forty-seven cases with complete SWE data were selected for analysis (mean age 54.3, range 21-92). The following variables were found to be independently associated with malignancy: age (P <.001), family history (P = .013), irregular mass shape (P = .024), and stiffness on SWE (mean SWE ≥40 kPa; P <.001). Remaining variables (including texture features) were not found to be independently associated with malignancy (P >.05). US texture analysis features were not associated with malignancy independent of other qualitative and quantitative US characteristics currently utilized in clinical practice. This suggests texture analysis may not be warranted when differentiating benign and malignant breast masses on US. In contrast, irregular mass shape on grayscale imaging and increased stiffness on SWE were found to be independent predictors of malignancy.

Comparative Study between Rocuronium And Magnesium Sulfate as Adjutants to Regional Anesthesia for Ophthalmic Surgeries using Peribulbar Block

Abstract Background Peribulbar anesthesia is frequently used in cataract surgeries. Compared to retrobulbar anesthesia, this approach is associated with less significant consequences. However, it has the disadvantages of a slower onset of orbital akinesia and the frequent requirement for block supplementation. Aim of the Work To evaluate the effect of addition of magnesium sulfate and rocuronium to standard local anesthetics mixture on the time of onset of globe and lid akinesia and corneal anesthesia for peribulbar block in ophthalmic surgeries. Patients and Methods This Prospective Double-blinded Randomized Study was carried out in the ophthalmic surgery unit, Ain Shams university hospital from January 2019 to April 2020. After institutional Ethical Board approval and obtaining written informed patients’ consents, 75 patients from both sexes, ASA physical status I-III, aged 40-80 years and having an Axial globe length less than or equals 26 mm scheduled for cataract surgery under peribulbar block were included in the study. Results Our study found statistically significant more rapid onset of action (mean time to start surgery) in rocuronium group (7.00±1.22) than control group and magnesium sulfate group (9.00±1.47 and 9.00±1.15) respectively, (p &amp;lt; 0.001); Moreover, no statistically significant difference was reported between control group and magnesium sulfate group. In addition, no significant difference was reported regarding duration of surgery between groups Conclusion Adding Rocuronium to local anesthetic mixture in peribulbar block during cataract surgery enhances ocular akinesia and corneal anesthesia and reduces the need for supplementary injections with no side effects and that was significantly better than Magnesium sulfate in term of rapid onset and time needed to achieve adequate condition to begin surgery. However, adding Magnesium sulfate showing good results regarding akinesia, corneal anesthesia and need for supplementary injections but it did not significantly fasten the onset of block and hence the time to start surgery.