---

Abstract Background & aim: MRI is a new and expensive diagnostic technology which has been increasingly used globally. This aim of study was to determining the administration of MRI for the Lumbar vertebrae using the appropriate RAND Method. Methods: This qualitative study was based on consensus. The population study included 9 professionals involved in prescribing the procedure based on Rand. Two criteria were identified: Valid clinical guidelines and expert opinion. Scoring criteria were the numbers 1 to 9. Numbers in the range of 1 to 3 unfit, 4 to 6, unreliable, and 7 to 9, placed in an appropriate range. An agreement was done when 7 specialists agreed marked the same range. Results: 97 scenarios were selected for the lumbar spine MRI in the extracting phase. 18 other scenarios were added by panel members. Finally, a total of 115 scenarios were identified. After implementing two rounds, the scenarios were categorized into three ranges. Sixty eight (%59.1) of the scenarios were considered as appropriate, 44(%38.2) as uncertain, and 3(%2.6) as inappropriate. Conclusion: A developed scenario in this project for MRI lumbar vertebrae treated with Guide is perfect for specialists. It is recommended that insurance companies and other institutions use this as a benchmark for the payment of MRI lumbar vertebrae fees. RAND appropriateness Method is useful for identifying stakeholder views in settings with limited resources. Key words: Lumbar Spine, Low Back Pain, RAND Appropriateness Method

---

Introduction & aim: To achieve high performance and health, it’s better to use additives in the human diet which have beneficial effects on good bacteria and damaging effect on the harmful bacteria. For this purpose, effects of Chavill extract on growth, viability and death of lactobacillus and salmonella, in skimmed milk and imaging gastric-intestine media were studied in vitro conditions. Methods: This study was investigated in two completely randomized experiments with three levels of Chavill extract. In the first experiment, ability of the Chavill extract in Skim Milk medium was examined to survey survival, proliferation and death of beneficial and pathogenic gut bacteria. The second experiment which was down in the simulation of simulated gastric juice and simulated small intestine juice, the effect of Chavill extract on survival, proliferation and death of the bacteria were investigated. Treatments in both of experiments were three levels of Chavill extract (0, 1, and 3 %) for three probiotic bacteria species. Data were analyzed with SAS 9.1 software and their means were compared by Duncan’s Multiple Range test at a significance level of 5 %. Results: By increasing of Chavill extract concentration to 1%, probiotic bacterial counts significantly increase compared to control treatment and the differences were significant and the count of Salmonella typhimurium difference with control significantly decreased. Using 3% Chavill extract compared to 1% extract, increased number of Lactobacillus acidophilus and Lactobacillus plantarum, decreased number of Lactobacillus casei, inhibit growth of Salmonella typhimurium bacterium and block growth of this bacterium. The second experiment on simulated gastric juice showed that numbers of Lactobacillus acidophilus and Lactobacillus plantarum bacteria increased and Lactobacillus casei and Salmonella typhimurium decreased. Also, findings of bacterial survival on simulated small intestine juice showed that there was no significant difference in bacterial on Lactobacillus acidophilus and Lactobacillus plantarum. Conclusion: Results showed that Chevill have good effects on binifical bacteria of digestive system and increases the number of beneficial bacteria and have harmful effects on pathogenic bacteria. It seemed that this plant could be used in diets and also for diseases causing imbalances of normal flora in the gastrointestinal tract. .