Plant-based traditional remedies and their role in public health: ethnomedicinal perspectives for a growing population

Abstract

Background

Traditional plant-based remedies remain essential to public health, especially in regions where formal healthcare access is limited. This study documents ethnomedicinal practices in Tehsil Hasilpur, Punjab, Pakistan, highlighting how growing and diverse populations utilize local flora for therapeutic purposes.

Methods

A total of 421 informants (247 males, 174 females) across 39 villages contributed to the documentation of 39 medicinal plant species from 19 botanical families. Informants represented varied age groups and occupations, including herbalists (25), farmers (18), and Pansars (15). Education levels varied, with 23 illiterate and 18 educated beyond matriculation. Preparation methods included powders (21), juices (15), decoctions (15), and infusions (14), with leaves (35) and whole plants (29) being the most used parts. Quantitative ethnobotanical indices such as Frequency Index, Use Value, and Rank Order Priority were calculated to assess plant significance. Informant Consensus Factor (ICF) was also determined for various ailment categories.

Results

Physalis peruviana exhibited the highest Frequency Index (3.78), while Rorippa sylvestris showed notable Use Value (0.57) and Rank Order Priority (32.57) for kidney stones and skin disorders. Informant Consensus Factor values ranged from 0.67 to 1.00, with strong agreement on treatments for ulcers, asthma, and urinary infections. The study also identified novel uses, such as Emex spinosus for fever and pain relief.

Conclusion

These findings emphasize the cultural and therapeutic relevance of ethnomedicine for growing populations. The preservation and pharmacological validation of such knowledge are vital, especially in areas with limited clinical infrastructure. Integrating scientifically supported traditional remedies into public health strategies could enhance healthcare accessibility while honoring indigenous knowledge systems.

Clinical trial number

Not applicable.

Supplementary Information

The online version contains supplementary material available at 10.1186/s41043-025-01036-5.

Introduction

Amidst accelerating urbanization and the globalization of healthcare systems, traditional plant-based remedies remain a cornerstone of public health, particularly in regions where access to modern medical care is limited. For generations, indigenous communities across the world have relied on wild and cultivated medicinal plants to treat a variety of health conditions. This ethnomedicinal knowledgetransmitted orally and through cultural practicesencompasses the identification, preparation, dosage, and spiritual context of plant use [1, 2]. Deeply rooted in local ecosystems, such practices reflect a nuanced understanding of the therapeutic properties of flora, developed through centuries of empirical observation and experience.

Notable examples from traditional systems underscore the pharmacological potential of ethnobotanical resources. The Amazonian Cinchona tree, once central to indigenous treatments, led to the discovery of quinine, an effective antimalarial compound [3]. Similarly, the use of Cordyceps fungi in Tibetan medicine illustrates the immunomodulatory capabilities of bioactive compounds derived from natural sources. Ceremonial uses, such as the Amazonian ayahuasca brewmade from Banisteriopsis caapi and Psychotria viridis highlight the intersection of therapeutic and spiritual dimensions in traditional medicine [4]. These examples demonstrate how plant-based remedies serve not only physiological needs but also broader cultural and psychological functions.

However, this rich legacy faces mounting challenges. Rapid urban expansion, habitat destruction, language loss, and diminishing intergenerational knowledge transfer threaten both plant biodiversity and the cultural systems that sustain ethnomedicinal knowledge [5]. Deforestation, mining, and climate change further reduce the availability of key medicinal species. Moreover, the commercialization of traditional remedies often occurs without adequate benefit-sharing or recognition of the communities who safeguard this knowledge, raising ethical and legal concerns.

In recent years, there has been a surge in scientific interest to validate and integrate traditional remedies into modern healthcare. For instance, Catharanthus roseus (Madagascar periwinkle), traditionally used in folk medicine, has yielded alkaloids now central to cancer treatment [6]. Likewise, ethnomedicinal sources are being explored for their antimicrobial, antioxidant, and anti-inflammatory properties, offering potential solutions to challenges such as antibiotic resistance and chronic diseases. This convergence of traditional wisdom with modern biomedical research opens new avenues for sustainable healthcare innovation.

Beyond direct medicinal uses, many wild plants contribute to nutritional security and resilience in vulnerable populations. The leaves of Moringa oleifera, for example, are rich in essential micronutrients and have been adopted as a food supplement to combat malnutrition in resource-limited settings [7]. Such multipurpose species exemplify the broader role of ethnobotanical knowledge in public health, food security, and ecological sustainability.

Pakistan, with its remarkable floral diversity comprising nearly 6,000 plant species, is a reservoir of ethnomedicinal knowledge. Traditional plant-based remedies remain vital in rural and semi-urban regions, where access to conventional healthcare is often restricted. Plants like Diospyros lotus and Trillium govanianum are widely utilized for treating ailments ranging from digestive disorders to inflammatory diseases [8, 9]. These practices are not merely remnants of the past but continue to play an active role in community health and wellbeing.

This study aims to document and analyze the ethnomedicinal practices in Tehsil Hasilpur, Punjab, Pakistanan area characterized by botanical richness and strong cultural ties to traditional medicine. By cataloging the local use of wild medicinal plants and examining their contemporary relevance, the study contributes to preserving biocultural heritage and informing sustainable healthcare development for a growing population.

Materials and methods

Study area

The present ethnobotanical study was conducted in Tehsil Hasilpur, District Bahawalpur, Southern Punjab, Pakistan. The region lies between the Satluj River and the Indian border and is located approximately 96 km east of Bahawalpur city, with geographical coordinates of N 294137.926 E 72 3301.617 (Fig.1, Fig. S1).

Fig. 1.

Geographic location of the study area in Tehsil Hasilpur, District Bahawalpur, Pakistan (The map was constructed using ArcGIS Online)

Hasilpur serves as the administrative headquarters of Hasilpur Tehsil and spans an area of 239,332 hectares. The population comprises approximately 317,513 inhabitants across 115 villages and the main city. Located adjacent to the Cholistan Desert, the area experiences a harsh climate with temperature extremes ranging from 2C to 50C, along with occasional sandstorms. The local economy is predominantly agricultural, supplemented by industries such as cotton ginning, brick kilns, vegetable ghee processing, and wheat milling. The regions culture is rooted in Punjabi traditions, with a strong emphasis on local cuisine prepared from indigenous ingredients [10, 11].

Ethnically, the region includes communities from various castes such as Arain, Awan, Jatt, Rajput, and Baloch. Languages commonly spoken include Punjabi dialects such as Majhi, Riasti, and Baagri. Islam is the predominant religion. Cultural practices are deeply rooted in Punjabi traditions, with the Shalwar Kameez being the traditional attire. The area is accessible by a network of roads, such as Chona Wala Road, that facilitate commerce and connectivity. A summary table of the visited villages is provided below in Table1.

Table 1.

Demographic and occupational characteristics of villages in the Hasilpur region

No.	Village Name	GPS Coordinates (N, E)	Altitude (m)	Ecology Type	Ethnicity	Language(s) Spoken	Religion	Inhabitants (Approx.)	Gender (M/F)	Age Range	Occupation(s)
1	Hasilpur Old	294137"N, 723301"E	117	Urban	Arain, Jatt	Punjabi, Saraiki	Islam	20,480	8/5	3070	Farmers, Shopkeepers
2	Hasilpur Mandi	294150"N, 723315"E	118	Urban	Rajput, Awan	Punjabi, Urdu	Islam	26,903	7/5	2865	Traders, Laborers
3	Hazrat Rangeela Shah	294210"N, 723420"E	119	Semi-Urban	Sheikh, Arain	Punjabi, Saraiki	Islam	22,264	7/4	3568	Farmers, Religious Leaders
4	Jamalpur	294230"N, 723510"E	120	Rural	Jatt, Rajput	Punjabi	Islam	22,970	7/4	3270	Farmers, Herbalists
5	Shahpur	29;4300"N, 723600"E	121	Rural	Arain, Awan	Punjabi, Saraiki	Islam	22,441	8/4	3065	Farmers, Teachers
6	Qaimpur	294330"N, 723650"E	122	Rural	Jatt, Rajput	Punjabi	Islam	23,792	7/4	2866	Farmers, Shopkeepers
7	Pallah	294400"N, 723740"E	123	Rural	Arain, Sheikh	Punjabi, Saraiki	Islam	23,230	8/5	3570	Farmers, Herbalists
8	Chak No. 58/F	294430"N, 723830"E	124	Rural	Jatt, Rajput	Punjabi	Islam	18,455	6/6	3068	Farmers, Laborers
9	Chak No. 79/F	294500"N, 723920"E	125	Rural	Arain, Awan	Punjabi, Saraiki	Islam	21,452	8/4	3270	Farmers, Teachers
10	Chak No. 89	294530"N, 724010"E	126	Rural	Jatt, Rajput	Punjabi	Islam	22,714	7/5	2865	Farmers, Shopkeepers
11	Choona Wala	294600"N, 724100"E	127	Rural	Arain, Sheikh	Punjabi, Saraiki	Islam	26,000	7/5	3068	Farmers, Herbalists
12	Chak No. 192/M	294630"N, 724150"E	128	Rural	Jatt, Rajput	Punjabi	Islam	18,717	7/4	3570	Farmers, Laborers
13	Chak No. 163/M	294700"N, 724240"E	129	Rural	Arain, Awan	Punjabi, Saraiki	Islam	26,401	7/4	2866	Farmers, Teachers
14	Chak No. 155/M	294730"N, 724330"E	130	Rural	Jatt, Rajput	Punjabi	Islam	2,860	7/4	3065	Farmers, Shopkeepers
15	Chak No. 160/M	294800"N, 724420"E	131	Rural	Arain, Sheikh	Punjabi, Saraiki	Islam	4,649	6/5	3270	Farmers, Herbalists
16	Chak No. 161/M	294830"N, 724510"E	132	Rural	Jatt, Rajput	Punjabi	Islam	3,360	6/5	2868	Farmers, Laborers
17	Chak No. 162/M	294900"N, 724600"E	133	Rural	Arain, Awan	Punjabi, Saraiki	Islam	2,053	7/4	3570	Farmers, Teachers
18	Chak No. 163/M	294930"N, 724650"E	134	Rural	Jatt, Rajput	Punjabi	Islam	561	7/5	3065	Farmers, Shopkeepers
19	Chak No. 179/M	295000"N, 724740"E	135	Rural	Arain, Sheikh	Punjabi, Saraiki	Islam	2,237	7/4	3270	Farmers, Herbalists
20	Chak No. 180/M	295030"N, 724830"E	136	Rural	Jatt, Rajput	Punjabi	Islam	2,610	6/6	2868	Farmers, Laborers
21	Chak No. 181/M	295100"N, 724920"E	137	Rural	Arain, Awan	Punjabi, Saraiki	Islam	1,671	6/4	3570	Farmers, Teachers
22	Chak No. 182/M	295130"N, 725010"E	138	Rural	Jatt, Rajput	Punjabi	Islam	2,227	5/4	3065	Farmers, Shopkeepers
23	Chak No. 183/M	295200"N, 725100"E	139	Rural	Arain, Sheikh	Punjabi, Saraiki	Islam	2,769	6/4	3270	Farmers, Herbalists
24	Chak No. 184/M	295230"N, 725150"E	140	Rural	Jatt, Rajput	Punjabi	Islam	2,104	6/4	2868	Farmers, Laborers
25	Chak No. 185/M	295300"N, 725240"E	141	Rural	Arain, Awan	Punjabi, Saraiki	Islam	1,262	6/3	3570	Farmers, Teachers
26	Chak No. 186/M	29°53’30"N, 72°53’30"E	142	Rural	Jatt, Rajput	Punjabi	Islam	1,365	5/4	30–65	Farmers, Shopkeepers
27	Chak No. 187/M	29°54’00"N, 72°54’20"E	143	Rural	Arain, Sheikh	Punjabi, Saraiki	Islam	2,230	6/4	32–70	Farmers, Herbalists
28	Chak No. 188/M	29°54’30"N, 72°55’10"E	144	Rural	Jatt, Rajput	Punjabi	Islam	2,115	6/4	30–68	Farmers, Herbalists
29	Chak No. 189/M	29°55’00"N, 72°56’00"E	145	Rural	Arain, Awan	Punjabi, Saraiki	Islam	1,890	6/3	33–70	Farmers, Teachers
30	Chak No. 190/M	29°55’30"N, 72°56’50"E	146	Rural	Jatt, Rajput	Punjabi	Islam	1,670	6/4	35–65	Farmers, Laborers
31	Chak No. 191/M	29°56’00"N, 72°57’40"E	147	Rural	Arain, Sheikh	Punjabi, Saraiki	Islam	1,540	6/4	30–70	Farmers, Shopkeepers
32	Chak No. 193/M	29°56’30"N, 72°58’30"E	148	Rural	Jatt, Rajput	Punjabi	Islam	1,312	5/4	28–65	Farmers, Herbalists
33	Chak No. 194/M	29°57’00"N, 72°59’20"E	149	Rural	Arain, Awan	Punjabi, Saraiki	Islam	1,480	6/4	34–68	Farmers, Teachers
34	Chak No. 195/M	29°57’30"N, 73°00’10"E	150	Rural	Jatt, Rajput	Punjabi	Islam	1,960	6/4	30–65	Farmers, Laborers
35	Chak No. 196/M	29°58’00"N, 73°01’00"E	151	Rural	Arain, Sheikh	Punjabi, Saraiki	Islam	1,402	5/4	32–70	Farmers, Shopkeepers
36	Chak No. 197/M	29°58’30"N, 73°01’50"E	152	Rural	Jatt, Rajput	Punjabi	Islam	1,670	5/4	29–66	Farmers, Herbalists
37	Chak No. 198/M	29°59’00"N, 73°02’40"E	153	Rural	Arain, Awan	Punjabi, Saraiki	Islam	1,580	5/5	34–65	Farmers, Teachers
38	Chak No. 199/M	29°59’30"N, 73°03’30"E	154	Rural	Jatt, Rajput	Punjabi	Islam	1,720	5/4	30–68	Farmers, Laborers
39	Chak No. 200/M	30°00’00"N, 73°04’20"E	155	Rural	Arain, Sheikh	Punjabi, Saraiki	Islam	1,910	10/6	35–70	Farmers, Shopkeepers

Ethno-botanical survey and data collection.

The study in Tehsil Hasilpur covered 39 villages, involving multiple field visits to engage with indigenous people and traditional healers (Vaidyas). Data collection employed semi-structured surveys, target interviews, and visual translation using the snowball method. A total of 421 respondents (247 males, 174 females) were randomly selected. Information on ethnomedicinal plants, including local names, uses, treated diseases, and herbal preparation methods, was gathered using a structured questionnaire during target interviews (Fig. S2; Research questionnaire). Plant specimens were collected during surveys, then shade-dried, pressed, and mounted on herbarium sheets for submission to the Botany Department, The Islamia University of Bahawalpur. Ethical protocols, including informed consent and confidentiality, were strictly followed. The study protocol received university ethical board approval. Plant names were verified using the International Plant Name Index to ensure accuracy and reliability in ethnomedicinal documentation (Fig. S3).

Ethical approval and consent to participate

The study was approved by the Research and Ethics Committee of The Islamia University of Bahawalpur (Protocol No. IUB/BOT/2023/49127454120). All interviews were conducted with informed consent, ensuring voluntary participation, confidentiality, and transparency about the study’s purpose and non-commercial intent. Verbal consent was obtained and documented prior to participation. Participants were not compensated and were debriefed following each interview.

Methods of quantitative ethnomedicinal data analysis

The data analysis encompassed the utilization of descriptive statistics, qualitative analysis and quantitative analysis methods. Some ethnobotanical information was examined using a Microsoft Excel sheet and SPSS version 26 [12].

Family importance value (FIV)

To evaluate the relative significance of families, the FIV was used. It was computed by dividing the number of informants who mentioned the family by the total number of informants [12].

FIV = .

Where “FC” is the number of informers revealing the family, while “N” is the total number of informants who participated in the research.

Popular therapeutic use value (POPUT)

POPUT is used to calculate the importance of a plant species for medicinal and therapeutic uses. Using the POPUT formula, values for POPUT were determined [12].

Where “NURIT” refers to the number of use reports for each sickness or treatment effect. “TUR” is the total number of use reports.

Informant consensus factor (ICF)

The Informant Consensus Factor was developed as a result of the search for the informant’s agreement on the stated treatment for each category of disease and determined by the given formula [12].

ICF = .

Where “Nur” explains the total use report for each category, while “Nt” explains the taxonomic numbers used. An estimate of the significance of each plant taxon in conventional knowledge is provided by consensus information-gathering methodology. The informant’s agreement with the species that are used to cure a specific ailment falls under the rank of high ICF.

Plant part value (PPV)

Plant part value is a measure of the relative importance of different plant parts in traditional medicines. The PPV of a plant species can vary depending on the cultural context and the specific needs of the community. It is computed what proportion of the plant’s components such as its root, seed, leaves, flower, fruit, etc. are used [13].

PPV (%) = 100.

Where of uses reported per part of the plant and total number of uses reported of all parts of the plant.

Relative frequency citation (RFC)

The formula below was used to calculate the index of the relative frequency of citations [6].

RFC = .

Where FC is the number of informants who reported using a species and N is the total number of informants.

Use value (UV) of plant species

The plant species and their overall state are not completely determined by their UV. Its value was calculated using the formula shown below [14].

UV = ∑ .

Where “UV” denotes each species’ use value, “Ui” indicates the number of uses recorded by each informant for a specific species, and “N” is the total number of informants.

Relative importance (RI)

According to their RI values, each plant species’ use and the body organ systems it treats are rated [14]. It is determined as.

RI = .

Where “R. Ph” denotes relative pharmacological traits. “R.Ph” is determined by dividing the number of uses (U) by the total number of use reports in the whole study. “R.BS” indicates relative body systems treated. The “R.BS” value is obtained by dividing the number of body systems treated by a plant species by the total number of body systems studied.

Fidelity level (FL)

To determine the value of the species associated with medicines, the fidelity level was determined [14].

FL (%) =x100.

“Np” is the number of species in a particular category. “N” is used to accurately total consumption for specific species.

Relative popularity level (RPL)

RPL is the ratio of the total number of informants for all diseases to the number of ailments healed by a specific plant species. Plant species with comparable FL may, however, have different therapeutic capacities. The RPL assumes a value between 0 and 1.0, with 0 denoting no ailments that a plant species treats and 1.0 denoting the entire popularity of a plant for significant ailments. The popularity index would be at its highest point (1.0) when all plant species were regularly employed to treat some serious illnesses; it would then decline toward zero as the relative popularity of the species veered away from the popular side. For species of popular plants, the RPL value is sensibly chosen to be unity (i.e., 1), but for species of unpopular plants, the RPL value is less than 1. It is determined whether a plant species is popular or unpopular based on its relative popularity level (RPL). Each plant’s RPL value can be calculated based on its precise location on a graph [14].

Rank order priority (ROP)

Plant species with different fidelity levels and Relative popularity level values are properly ranked using a correction factor known as ROP. The ROP is made from the FL by multiplying the RPL and ROP values [14].

ROP .

Frequency index (FI)

To summarize the ethnobotanical data, a descriptive statistical method (percentage and/or frequency) was used. The Frequency Index (FI) was calculated using the following formula for the quantitative data analysis of the ethnomedicinal plants [15].

Where “FC” is the number of traditional healers who mentioned the use of species and “N” is the total number of respondents.

Cultural significance index (CSI)

The cultural significance index was used to determine how well-aligned informant knowledge was with the use of reports for a particular species. The following formula was used to calculate it [15].

While “i” refers to the management of species that significantly affect the community, “e” indicates the informant’s preference for one plant species over another for a specific purpose (value 2 for preferred species and value 1 for non-preferred species) and the letter “c” denotes the frequency of use of a plant species (a species that is cultivated, managed, or operated in any way receives a score of 2 and a score of 1 if the species is still free of any kind).

Family use value (FUV)

Family use value is a measure of the importance of plant species to a particular family. To determine the significance of plant families, the FUV is calculated by using this formula [16].

FUV=.

Where “ns” is the overall number of species within a family and “UVs” is the total usage value of all the species within that family.

Jacquard index

This index is used to compare study data to other ethnobotanical studies undertaken in different countries around the world, as well as among indigenous groups in the examined locations. The formula for calculating the JI index was [16]:

JI= .

where “a” is the recorded number of species of the study area “A,” “b” is the documented number of species of the area “B” and “c” is the common number of species in both areas “A” and “B.”

Results and discussion

Socio-demographic features of informants

A total of 421 individuals were interviewed, comprising 247 males and 174 females. The informants included herbalists (104), farmers (77), Pansars (63), and others (176). Age distribution was as follows: 78 individuals were between 30 and 40 years, 116 between 40 and 50 years, 114 between 50 and 60 years, and 112 were over 60 years of age. Regarding literacy, 23% of respondents were illiterate, 22% had primary education, 13% had middle-level education, 24% had matric-level education, and 18% had education beyond matric. Occupational breakdown showed 25% were herbalists, 15% Pansars, 18% farmers, and 42% from other professions. A total of 19 plant families and 39 medicinal plant species were reported (Table 2).

Table 2.

Socio-demographic characteristics of informants in the ethnobotanical study of wild medicinal flora, detailing variables such as age, gender, education level, and occupation

Characteristics	Class	Numbers	Percentage
Gender	Female	174	41.33
	Male	247	58.66
Age(year)	31–40	78	18
	41–50	116	28
	51–60	114	27
	Above 60	112	27
Occupation	Farmer	77	18
	Herbalist	104	25
	Pansars	63	15
	Others	176	42
Education	Illiterate	97	23
	Primary	91	22
	Middle	55	13
	Matric	102	24
	Above matric	75	18

The lower female representation reflects gender imbalances commonly reported in ethnobotanical studies. Factors such as cultural norms, societal roles, and accessibility contribute to this trend, as noted in existing literature. The prominence of herbalists and Pansars among respondents aligns with their active roles in traditional medicinal practices [17]. Notably, the highest volume of ethnomedicinal data originated from the 40–50 age group, whereas the illiterate group contributed the least. These patterns are consistent with previous findings indicating that middle-aged and more educated individuals typically possess and share more ethnobotanical knowledge [18–20].

Growth habits of wild ethnomedicinal flora

In total, 39 plant species from 19 families were documented in the study area. Among these, 64% were perennial and 36% were annual (Fig. 2a). Growth form analysis showed that herbs accounted for 54% of species, followed by trees (20%), shrubs (13%), and weedy grasses (13%) (Fig. 2b).

Fig. 2.

Growth habits of wild ethnomedicinal flora in terms of (a) life span categories (annual, perennial) and (b) life form (herbs, shrubs, trees, grass)

The dominance of perennial plants mirrors findings from other ethnobotanical studies, which attribute this trend to their consistent availability and reliable medicinal properties. Similarly, the prevalence of herbs is a common feature across ethnobotanical literature, likely due to their accessibility and versatility in traditional medicine. These results are comparable to studies conducted in Haripur [21] and Thana Town, Malakand [6], where similar trends were observed.

Method of preparation

Among the documented preparation methods for medicinal plants, powders were the most common (21%), followed by juice and decoction (15%), infusion (14%), herbal tea (12%), paste (11%), and other methods (12%) (Fig. 3). Less commonly used methods included raw, liquid, and ash preparations. Regarding plant parts utilized, leaves were the most frequently used (28.88%), followed by seeds (16%).

Fig. 3.

Distribution of Preparation Methods Used in Traditional Remedies for Disease Treatment

The preference for powder, juice, and decoction aligns with existing ethnobotanical literature, which highlights these methods for their simplicity, effectiveness in extracting bioactive compounds, and ease of storage and administration. Their widespread use likely reflects practical advantages such as consistent dosing and preservation of medicinal properties. In contrast, less common methodslike raw, liquid, or ash-based preparationstend to be employed for specific plants or conditions, often influenced by cultural preferences or regional traditions. Similar trends were observed in related studies, where decoction (71.4%), extract (66.7%), and infusion (38.1%) were the most utilized techniques, while juice and ash were reported as least common (14.3%) [10].

Quantitative ethnobotanical data analysis

Family importance value (FIV)

The most represented plant family in the study was Poaceae (21%), followed by Fabaceae (17%). Other families included Asteraceae (8%), Solanaceae (6%), Chenopodiaceae (6%), Rhamnaceae (6%), Amaranthaceae (6%), and Polygonaceae (6%) (Fig. 4). Solanaceae and Chenopodiaceae each contributed three species. Asphodelaceae, Euphorbiaceae, and Convolvulaceae were represented by two species each. All remaining families had one species each.

Fig. 4.

Family Importance Value (FIV) of ethnomedicinal plant families in the study area

The high representation of Poaceae and Fabaceae may be attributed to their ecological abundance, wide geographic distribution, and recognized therapeutic potential. These families are commonly cited in ethnobotanical literature due to their diverse phytochemical profiles and adaptability to various habitats. In contrast, families with lower FIV scores may be underrepresented because of their restricted regional occurrence, specific ecological niches, or limited cultural familiarity. These findings are consistent with previous studies emphasizing how ecological availability and local ethnomedical traditions shape the prominence of plant families in traditional healthcare systems [12, 22, 23].

Popular therapeutic use value (POPUT)

In the study area, the POPUT, which quantifies the medicinal relevance of plants for specific health conditions, ranged from 0.112 to 0.009. The most commonly reported ailments were skin disorders and coughs, both with the highest POPUT value of 0.112. These were followed by kidney stones (0.095), arthritis (0.090), digestive disorders (0.086), wound healing (0.076), and fevers (0.067). Asthma and diuretic-related issues each had a POPUT value of 0.064, while constipation (0.059), pain relief (0.047), diabetes (0.038), and urinary diseases (0.036) were also reported. Less frequent conditions included diarrhea and flu (0.0167 each), female disorders and paralysis (0.014 each), earaches (0.011), and ulcers (0.009) (Table 3).

Table 3.

Popular therapeutic use value (POPUT) and informant consensus factor (ICF) of medicinal plant species for various ailments

Diseases	ICF	POPUT
Anti-inflammatory	0.8	0.026
Arthritis	0.78	0.09
Asthma	0.81	0.064
Constipation	0.71	0.059
Cough	0.74	0.112
Diabetes	0.73	0.038
Diarrhea	0.67	0.0167
Digestive disorders	0.74	0.086
Diuretic	0.81	0.064
Dysentery	0.75	0.021
Earache	1	0.011
Eye diseases	0.78	0.023
Female disorders	0.6	0.014
Fever	0.81	0.067
Flu	1	0.0167
Hair treatment	1	0.012
Hemorrhages	1	0.017
Kidney stone	0.84	0.095
Liver disorders	0.86	0.019
Pain killer	0.79	0.047
Paralysis	1	0.014
Production and purification of blood	0.71	0.019
Skin disorders	0.74	0.112
Ulcer	1	0.009
Urinary diseases	0.86	0.036
Wound healing	0.77	0.076

The predominance of skin disorders and coughs corresponds with global health patterns, often influenced by environmental factors, poor air quality, infections, and seasonal changes. These high POPUT values suggest that such ailments are not only prevalent in the community but are also considered important enough to warrant consistent treatment using ethnomedicinal knowledge. Conversely, the lower POPUT values for conditions like ulcers, female disorders, and paralysis may reflect limited awareness, cultural stigma, or less frequent occurrence in the population. These patterns are in line with previously documented health trends, which emphasize the influence of environmental and lifestyle factors on disease prevalence and medicinal plant usage [12, 14].

Informant consensus factor (ICF)

In total, 39 plant species from 19 different families were reported to treat various diseases. The ICF, which measures the degree of agreement among informants regarding plant use for specific ailments, ranged from 0.60 to 1.00 (Table 3). The highest ICF values (1.00) were recorded for earaches, ulcers, paralysis, flu, hair treatment, and hemorrhages. Liver disorders and urinary diseases followed closely with values of 0.86. Kidney stones had an ICF of 0.84, while asthma, fever, and diuretic-related ailments each had an ICF of 0.81. Anti-inflammatory uses showed a high consensus with an ICF of 0.80. The lowest values were found for diarrhea (0.67) and female disorders (0.60).

These high ICF values imply a strong level of shared knowledge among informants regarding the efficacy of specific plant species in treating certain ailments. This consensus suggests that traditional remedies for these conditions are well-established and widely accepted within the community. Notably, ailments like ulcers and paralysis, despite their relatively low POPUT values, exhibited perfect consensus, indicating specialized knowledge or reliance on highly trusted remedies. On the other hand, the lower ICF values observed for diarrhea and female disorders may result from greater variation in treatment approaches, diverse plant availability, or sociocultural sensitivities that influence disclosure. Literature often links such variations in ICF values to the perceived effectiveness of remedies, cultural preferences, and the prevalence of diseases in different regions [3, 12, 23, 24].

Plant part value (PPV)

Various plant components were used in ethnomedicinal practices reported by informants. Leaves were the most frequently utilized part, accounting for 35% of all reported uses. Whole plants were used in 29% of cases, followed by roots (12%), fruits (7%), seeds (6%), and both stems and flowers (4% each). Bark, tubers, and green wings were less commonly used, each accounting for 3%, 1%, and 1%, respectively (Fig. 5). Specifically, leaves appeared in 38% of all documented traditional remedies, followed by stems and roots (10% each), and fruit, seed, and flower (7% each).

Fig. 5.

Percentage Utilization of Different Plant Parts in Ethnomedicinal Applications for Various Ethnomedicinal Plants

The dominant use of leaves aligns with many ethnobotanical studies, where leaves are commonly preferred due to their easy accessibility and high concentrations of bioactive compounds. Leaves can be harvested sustainably without harming the plant, making them both ecologically and practically favorable for continued use. Whole plants and roots, though less sustainable, are often associated with stronger or more holistic therapeutic effects. The infrequent use of plant parts such as bark, tubers, and green wings may be attributed to cultural specificity, lower phytochemical content, or niche applications. These findings mirror trends observed in previous ethnobotanical surveys, where leaf use was reported in 30.2–61.5% of cases, with fruits, stems, and rhizomes as commonly reported alternatives [25–27].

Relative frequency citation (RFC)

The RFC for plant species in the study ranged from 0.038 to 0.017 (Table 4). The species with the highest RFC was Physalis peruviana (0.038), followed closely by Digera muricata, Datura metel, Zaleya pentandra, and Cynodon dactylon, each with a value of 0.035. Other notable species included Cuscuta reflexa, Aerva javanica, and Calotropis procera, all with RFC values of 0.033. The lowest RFC values, 0.017, were recorded for Verbascum virgatum and Rorippa sylvestris.

Table 4.

Ethnobotanical traits and uses of medicinal plants by Indigenous communities in the study area

BN/ Voucher no.	LN	Family	Life Form with Status	PU	Rec	App	Uses	RFC	UV	RI	FL%	RPL	ROP	FI	CSI	Previously reported uses
Acacia ampliceps Maslin 313/Botany	Australian kikar	Fabaceae	Perennial tree (Exotic)	Whole plant	Herbal tea, Powder, juice,	Oral	*Skin disorders, digestive disorders and diabetes	0.02	0.37	9	50%	0.37	18.75	2.02	1.06	1 2 3 4 5 6 7 8 9 10
Vachellia nilotica (L.) P.J.H. Hurter Mabb. 301/Botany	Kikar	Fabaceae	Perennial tree (Native)	Seeds, leaves	Dried powder, Fresh paste	Oral	*Diabetes cough fever dysentery	0.03	0.33	6.72	50%	0.33	16.67	3.02	3.2	1 2 3 4 5 6 7 8 9 10
Aerva javanica Juss. 290/Botany	Booh	Amaranthaceae	Perennial shrub (Native)	Whole plant	herbal tea, powder, paste	Oral, Massage	*Skin disorders Arthritis kidney stone	0.032	0.23	8.52	46%	0.23	10.61	3.27	3.47	1 2 3 4 5 6 7 8 9 10
Albizia lebbeck (L.) Benth. 298/Botany	Shirin	Fabaceae	Perennial tree (Naturalized)	Seeds, leaves and flowers	Seed powder, tea and decoctions	Massage, Topical	*Eye diseases skin disorders wound healing pain killer	0.03	0.33	5.07	33%	0.33	11	3.02	3.2	12 3 4 5 6 7 8 9 10
Calotropis procera (Aiton) Dryand. 292/Botany	Aak	Apocynaceae	Perennial shrub (Native)	Leaves and flowers	Dried flowers, Leaves juice	Oral, Massage	*Arthritis asthma digestive disorders	0.032	0.31	7.44	46%	0.31	14.15	3.27	1.734	1 2 3 4 5 6 7 8 9 10
Capparis decidua Edgew. 297/Botany	Karri deela	Capparaceae	Perennial shrub/tree (Native)	Fruits seed	Fresh juice, paste	Oral, Topical	*Production and purification of blood arthritis cough asthma	0.03	0.33	7.31	42%	0.33	1.344	3.02	3.2	1 2 3 4 5 6 7 8 9 10
Cassia fistula L. 299/Botany	Amaltas	Caesalpiniaceae	Perennial tree (Exotic)	Leaves, fruits seed	Powder, Decoction, Herbal tea	Oral	*Arthritis skin disorders fever constipation	0.028	0.36	7.2	46%	0.36	16.72	2.77	2.92	1 2 3 4 5 6 7 8 9 10
Cenchrus biflorus Roxb. 303/Botany	Pasra	Poaceae	Annual grass (Native)	Whole plant	Dried seed powder and fresh paste of whole plant	Oral	*Asthma cough diuretic	0.018	0.43	7.32	36%	0.43	15.43	1.76	0.467	1 2 34 5 6 7 8 9 10
Cenchrus ciliaris L. 296/Botany	Dhaman	Poaceae	Perennial herb (Naturalized)	Whole plant	Leaves infusion and decoction	Oral	*Pain killer urinary diseases kidney stone	0.03	0.25	7.56	57%	0.25	14.25	3.02	1.6	1 2 3 4 5 6 7 8 9 10
Chenopodium murale L. 291/Botany	krund	Chenopodiaceae	Annual herb (Exotic)	Whole plant	fresh paste of leaves, dried seed powder, herbal tea of stem	Oral	*Digestive disorders diarrhea constipation ulcer diuretic	0.032	0.39	9.12	50%	0.39	19.23	3.27	3.468	1 2 3 4 5 6 7 8 9 10
Cistanche deserticola Ma 318/Botany	Geedar tobacco	Orobanchaceae	Perennial herb (Exotic)	Whole plant	Herbal tea and dried powder	Oral and massage	*Arthritis diarrhea cough	0.02	0.37	6.62	38%	0.37	14.25	2.02	1.06	1 2 3 4 5 6 7 8 9 10
Erigeron canadensis L. 307/Botany	Aspi grass	Asteraceae	Annual herb (Exotic)	Whole plant	Leaves decoctions and whole plant infusion	Oral	*Production and purification of blood hemorrhage	0.025	0.20	7.43	38%	0.20	7.6	2.52	1.334	1 2 3 4 5 6 7 8 9 10
Cuscuta reflexa Roxb. 284/Botany	Akas bail	Convolvulaceae	Perennial herb (Native)	Whole plant	Essential oil of stem, infusion of whole plant	Oral, massage and Topical	*Pain killer paralysis hair treatment	0.032	0.23	9.16	70%	0.23	16.15	3.27	3.47	1 2 3 4 5 6 7 8 9 10
Cynodon dactylon (L.) Pers. 295/Botany	Khabal grass	Poaceae	Perennial grass (Native)	Whole plant	leaves paste, dried powder of whole plant	Oral, Topical	wound healing *Digestive disorders eye diseases skin disorders	0.035	0.29	9	36%	0.29	10.29	3.53	3.73	1 2 34 5 6 7 89 10
Dactyloctenium aegyptium (L.) Willd. 288/Botany	Madana grass	Poaceae	Annual herb (Native)	Whole plant	Juice, paste, decoction	Oral, Topical	*Digestive disorders fever	0.032	0.15	6.96	69%	0.15	10.62	3.27	3.46	1 2 3 4 5 6 7 8 9 10
Datura metel L. 286/Botany	Datura	Solanaceae	Annual herb (Exotic)	Whole plant	Herbal tea, infusion and decoction	Oral and massage	*Earache cough wound healing	0.035	0.21	6.6	43%	0.21	9.21	3.53	1.866	1 2 3 4 5 6 7 8 9 10
Digera muricata Mart. 285/Botany	Taandla	Amaranthaceae	Annual herb (Native)	Whole plant	Paste, juice and infusion	Oral, Topical	*Wound healing female disorders skin disorders arthritis	0.035	0.29	6.99	43%	0.29	12.29	3.53	3.73	1 2 3 4 5 6 7 8 9 10
Emex spinosa (L.) Campd. 308/Botany	Trkandi Palak	Polygonaceae	Annual herb (Native)	Whole plant	herbal tea of leaves and decoction	Oral	*Fever pain killer female disorders	0.025	0.30	9.35	70%	0.30	0.9338	2.52	1.334	1 2 3 4 5 6 7 8 9 10
Eragrostis cilianensis (All.) Vignolo ex Janch. 317/Botany	Candy grass	Poaceae	Annual grass (Native)	Whole plant	Fresh juice and dried powder	Oral, Topical	*Cough, kidney stones,	0.023	0.22	6.99	78%	0.22	17.33	2.27	0.6	1 2 3 4 5 6 7 8 9 10
Gamochaeta pensylvanica (Willd.) Cabrera 319/Botany		Astraceae	Annual herb (Exotic)	Stem, leaves	Herbal tea, decoction	Oral	*Digestive disorders diarrhea diabetes	0.018	0.43	9.12	43%	0.43	18.42	1.76	0.467	1 2 3 4 5 6 7 8 9 10
Leptochloa fusca Kunth 283/Botany	Kallar grass	Poaceae	Perennial grass (Native)	Whole plant	Dried powder, herbal tea, paste	Oral, massage	*Skin disorders liver disorder Arthritis wound healing	0.021	0.44	7.11	44%	0.44	19.56	2.14	1.2	1 2 3 4 5 6 7 8 9 10
Launaea nudicaulis (L.) Hook.f. 287/Botany	Bathal	Solanaceae	Annual herb (Native)	Leaves, seed, stem	Leave infusion and essential oil	Oral, massage and Topical	*Arthritis skin disorders constipation	0.03	0.25	9.12	42%	0.25	10.5	3.02	3.2	1 2 3 4 5 6 7 8 9 10
Leucaena leucocephala (Lam.) de Wit 306/Botany	Jungle shirin	Fabaceae	Perennial tree (Exotic)	Seed, leaves	Dried powder and herbal tea, juice	Oral	*Digestive disorders diabetes female disorders	0.025	0.30	6.99	50%	0.30	1.335	2.52	2.67	1 2 3 4 5 6 7 8 9 10
Melilotus indicus (L.) All. 302/Botany	Sainji	Fabaceae	Perennial herb (Naturalized)	Whole plant	paste, dried powder, infusion	Oral, Topical	*Diuretic skin disorders wound healing digestive disorders	0.028	0.36	11.23	45%	0.36	16.36	2.77	1.466	1 2 3 4 5 6 7 8 9 10
Panicum antidotale Retz. 310/Botany	Bansi grass	Poaceae	Perennial grass (Native)	Seed, stem, leaves	Decoction, herbal tea	Oral	*Production and purification of blood cough arthritis	0.025	0.30	4.92	40%	0.30	1.068	2.52	2.67	1 2 3 4 5 6 7 8 9 10
Persicaria lapathifolia (L.) Delarbre 314/Botany		Polygonaceae	Annual herb (Native)	Whole plant	Fresh plant juice, decoction, dried powder	Oral	*Fever, digestive disorders, dysentery	0.023	0.33	9.36	44%	0.33	14.67	2.27	1.2	1 2 3 4 5 6 7 8 9 10
Phalaris minor Retz. 312/Botany	Dumbi siti grass	Poaceae	Annual herb (Exotic)	Fruit, leaves	Leave infusion and herbal tea, fruit juice	Oral	*Diuretic cough dysentery	0.025	0.30	6.6	40%	0.30	0.5336	2.52	1.334	1 2 3 4 5 6 7 6 7 8 9 10
Physalis peruviana L. 294/Botany	Kakanj	Solanaceae	Perennial shrub (Exotic)	Fruit, leaves	Fresh fruit juice and dried fruit powder	Oral	*Constipation kidney stone liver disorder	0.038	0.20	6.96	47%	0.20	1.88	3.78	4	1 2 3 4 5 6 7 8 9 10
Prosopis cineraria (L.) Druce 309/Botany	Jand	Fabaceae	Perennial tree (Native)	Bark, leaves, seed	Paste, powder, juice	Oral, topical	*Arthritis Cough asthma	0.028	0.27	6.96	45%	0.27	12.27	2.77	2.92	1 2 3 4 5 6 7 8 9 10
Rorippa sylvestris (L.) Besser 278/Botany		Brassicaceae	Perennial herb (Exotic)	Flowers, leaves	Decoction, dried powder	Oral, topical	*Wound healing skin disorders urinary diseases kidney stone	0.017	0.57	6.75	57%	0.57	32.57	1.67	0.467	1 2 3 4 5 6 7 8 9 10
Saccharum bengalense Retz. 311/Botany	Surkanda	Poaceae	Perennial shrub (Native)	Root, leaves	Leave juice used, powder, decoction	Oral, topical	*Skin disorders fever constipation wound healing	0.03	0.33	5.39	25%	0.33	8.33	3.02	3.2	1 2 3 4 5 6 7 8 9 10
Spergula arvensis L. 305/Botany	Jungli dhania	Caryophyllaceae	Annual herb (Exotic)	Leaves, seed	Fresh infusion of leaves	Oral	*Kidney stone diuretic	0.018	0.29	6.87	71%	0.29	20.29	1.76	0.467	1 2 3 4 5 6 7 8 9 10
Suaeda nigra (Raf.) J.F. Macbr. 304/Botany	Laani	Chenopodiaceae	Perennial herb (Exotic)	Leaves, stem	Infusion, juice, paste	Oral, topical	*Constipation eye diseases skin disorders	0.025	0.33	8.76	40	0.33	0.5336	2.52	1.334	1 2 3 4 5 6 7 8 9 10
Tribulus terrestris L. 293/Botany	Bakhra	Zygophyllaceae	Annual herb (Native)	Flowers, fruits	juice, decoction, dried powder	Oral	*Cough urinary diseases kidney stone	0.032	0.23	4.7	54	0.23	12.46	3.27	3.468	1 2 3 4 5 6 7 8 9 10
Verbascum virgatum Stokes 320/Botany		Scrophulariaceae	Perennial herb (Exotic)	Flowers, leaves	Decoction, infusion	Oral	*Cough asthma diuretic	0.017	0.43	9.24	57	0.43	24.43	1.67	0.467	1 2 3 4 5 6 7 8 9 10
Vicia hirsuta (L.) Gray 316/Botany	Jungli matri	Fabaceae	Annual herb (Exotic)	Leaves, seed	Herbal tea, powder	Oral	*Pain killer anti- inflammatory	0.023	0.22	7.32	67	0.22	14.89	2.27	1.2	1 2 3 4 5 6 7 8 9 10
Zaleya pentandra (L.) C. Jeffrey 289/Botany	Iit sit	Azoaceae	Perennial herb (Native)	Whole plants	Juice, powder, juice	Oral	*Cough kidney stone digestive disorders	0.035	0.21	4.92	50	0.21	10.71	3.53	3.73	1 2 3 4 5 6 7 8 9 10
Ziziphus jujuba Mill. 300/Botany	Beri	Rhamnaceae	Perennial tree (Native)	Fruit, leaves, seed	Decoction, infusion and powder	Oral	*Constipation, cough asthma	0.025	0.30	7.2	50	0.30	1.335	2.52	2.67	1 2 3 4 5 6 7 8 9 10
Ziziphus nummularia (Burm.f.) Wight Arn. 315/Botany	Paindo beri	Rhamnaceae	Perennial tree (Native)	Fruits, seed	Fresh fruit juice and dried fruit powder	Oral	*Diabetes skin disorders anti-inflammatory	0.025	0.30	6.96	50	0.30	1.335	2.52	2.67	1 2 3 4 5 6 7 8 9 10

The scientific names of all recorded plant species were authenticated using the Plants of the World Online (POWO) database, maintained by the Royal Botanic Gardens, Kew (POWO, 2021). Abbreviations: BN (Botanical name), LN (Local name), LF (Life form), PPU (Plant Part used), Rec (Recipe), App (Mode of application), UV (Use value), FL (Fidelity level), RFC (Relative frequency citation), RPL (Relative popularity level), ROP (Rank order priority), FI (Frequency index), CSI (Cultural significance index), RI (Relative importance), This plant is known to have toxic properties and caution should be exercised, *Novel use ()=Plant with similar use, ()=Plant with dissimilar use, ();=Plant not reported in the previous study, 1: Altaf et al. (2019), 2: Wariss et al. (2014), 3: Fatima et al. (2019), 4: Khan et al. (2012), 5: Hussain et al. (2015), 6: Azhar et al. (2022), 7: Uzun and Koca (2020), 8: Haider and Zhong (2014), 9: Ismail et al. (2010), 10: Hu et al. (2020).

These RFC values reflect the degree of familiarity and frequency of use of each species among local informants. Higher RFC values, as seen for Physalis peruviana and Datura metel, indicate widespread traditional use and possibly well-established therapeutic roles. Such trends are consistent with other ethnobotanical surveys, such as the high RFC reported for Viola canescens in Azad Jammu and Kashmir [27] and Rosa indica in District Lahore [17]. The RFC metric is influenced primarily by the number of informants citing each species, highlighting its cultural prominence and perceived efficacy in traditional healing practices [28].

Use value (UV) of plant species

The UV, which reflects the relative importance of each plant based on the number of uses cited by informants, ranged from 0.57 to 0.15 in the current study (Table 4). The highest UV was recorded for Rorippa sylvestris (0.57), followed by Leptachloa fusca (0.44), and Cenchrus biflorus, Gamochaeta pensylvanica, and Verbascum virgatum (0.43 each). These plants were commonly reported for the treatment of ailments such as asthma, liver disorders, and skin diseases. Conversely, the lowest UV values (0.01) were observed for Alhagi maurorum, Eclipta prostrata, and Trianthema portulacastrum.

Higher UV values indicate both broad and repeated use of these species in treating multiple diseases, suggesting strong community reliance and sustained ethnomedicinal knowledge. These findings are consistent with previous studies that associate high UV values with plants recognized for their therapeutic efficacy, broad pharmacological properties, and cultural importance in traditional healthcare systems [3]. UV serves as a composite measure of both versatility and popularity of a species in folk medicine, offering a quantitative view of its significance.

Relative importance (RI)

The RI values for the plant species ranged from 4.7 to 11.23 (Table 4). The highest RI was found in Chenopodium murale (11.23), followed by Cynodon dactylon (9.36), Digera muricata (9.35), and Calotropis procera (9.24). Other species also showed considerable RI values, reflecting their roles in treating multiple health disorders.

A higher RI score indicates a plant’s ability to treat a wide range of diseases affecting various body systems, and often correlates with both therapeutic diversity and cultural entrenchment. These findings support ethnobotanical literature that identifies high-RI species as having extensive applications and high local importance due to their effectiveness and the presence of bioactive constituents [17]. The RI thus helps prioritize species for further pharmacological and phytochemical investigation based on their holistic significance in traditional medicine.

Fidelity level (FL)

FL was used to determine the consistency of use of certain plant species for specific ailments. Among the 39 species studied, the highest FL was observed for Eragrostis cilianensis (78%) for treating flu, Spergula arvensis (71%) for kidney stones, and Erigeron canadensis (70%) for hemorrhages. Emex spinosus also showed a high FL (70%) as a painkiller, while Dactyloctenium aegyptium (69%) and Vicia hirsuta (67%) were primarily used for fever and inflammation, respectively. The lowest FL value (25%) was recorded for Saccharum bengalense, which was used in treating skin diseases (Table 4).

High FL values indicate strong cultural consensus and belief in the efficacy of certain species for treating particular conditions. These results align with prior studies where species such as Solanum americanum (66.14%) and Azadirachta indica (93.4%) were reported with similarly high FL values, reflecting the reliability and targeted use of such species in community healthcare [3, 24]. FL thus provides insight into how specific plants are trusted for particular ailments, offering valuable direction for pharmacological validation.

Relative popularity level (RPL)

T he RPL of plant species in the study area ranged from 0.57 to 0.15 (Table 4). The highest RPL value was recorded for Rorippa sylvestris (0.57), followed by Leptachloa fusca (0.44), Cenchrus biflorus, Gamochaeta pensylvanica, and Verbascum virgatum (0.43 each). These species were commonly used for treating constipation, asthma, liver problems, skin conditions, and blood purification.

RPL reflects how widely a plant is recognized and accepted in folk medicine within the community. The higher values observed for the aforementioned species indicate their prominent role in treating common ailments and the population’s familiarity with their applications. These findings resonate with other ethnobotanical reports, such as those from regions where Solanum surattense and Withania somnifera had RPL values of 1.0, denoting even higher cultural embedding. While our study recorded comparatively lower RPL values, the consistency of these findings highlights the relative popularity and practical relevance of these species in local healthcare traditions [12]. This emphasizes the continuing importance of indigenous knowledge systems in maintaining effective traditional health practices.

Rank order priority (ROP)

The ROP values were calculated to determine the priority of plant species based on their perceived therapeutic efficacy and ethnomedicinal significance (Table 4). Rorippa sylvestris ranked highest (ROP = 32.57) for its application in treating kidney stones, followed by Verbascum virgatum for asthma, and Emex spinosus for pain relief. Several other species were identified as important in the treatment of digestive disorders, flu, and skin-related ailments. In contrast, Erigeron canadensis had the lowest ROP value (7.6), indicating a comparatively lower ethnopharmacological importance.

Higher ROP values typically correspond to species with documented bioactive compounds, validated therapeutic applications, and long-standing use in traditional medicine. These values not only reflect cultural preferences but also guide the prioritization of plants for further pharmacological research. The distribution of ROP values in the current study aligns with patterns reported in previous ethnobotanical investigations. For example, in Bhimber, Azad Jammu and Kashmir, ROP values exceeding 50 were uncommon, whereas in the present study, moderately high ROP scores such as that of Rorippa sylvestris (32.57) suggest a relatively higher local reliance on certain species [29, 30].

Frequency index (FI)

The FI was used to assess how frequently each plant species was cited by informants, serving as an indicator of local usage trends (Table 4). Physalis peruviana exhibited the highest FI at 3.778, followed closely by Digera muricata, Datura metel, Zaleya pentandra, and Cynodon dactylon, each with an FI of 3.526. A group of other species, including Cuscuta reflexa, Aerva javanica, Dactyloctenium aegyptium, Chenopodium murale, Calotropis procera, and Tribulus terrestris, shared an FI of 3.275. Slightly lower FI values (3.023) were recorded for species such as Launaea nudicaulis, Cenchrus ciliaris, Vachellia nilotica, Capparis decidua, Albizia lebbeck, and Saccharum bengalensis. The lowest FI values were found in Cenchrus biflorus, Spergula arvensis, Gamochaeta pensylvanica, Verbascum virgatum, and Rorippa sylvestris, ranging from 1.763 to 1.667.

Higher FI values suggest a greater frequency of use and stronger cultural recognition of these species, underscoring their prominence in local ethnomedicinal knowledge systems. The prominence of Physalis peruviana and Digera muricata, for instance, reflects both their accessibility and perceived efficacy. These findings are consistent with literature from other regions. For example, in South Africa, Elephantorrhiza elephantina had the highest FI, while Aloe grandidentata recorded the lowest [31]. In Nepal, FI values for species such as Achyranthes aspera (14.81), Centella asiatica (30.86), Dioscorea bulbifera (74), Mimosa pudica (13.58), and Jatropha curcas (7.40) highlighted similar reliance on key plant species [28]. Thus, FI provides a robust quantitative measure for identifying culturally significant and frequently used plants in traditional healthcare.

Cultural significance index (CSI)

The CSI evaluates the cultural and medicinal importance of plant species by integrating their use frequency, versatility, and sociocultural value (Table 4). Physalis peruviana exhibited the highest CSI (4.0), reflecting its widespread application in treating kidney stones, liver disorders, and constipation. Other highly ranked species included Digera muricata (CSI = 3.73), known for treating arthritis, female reproductive issues, and wound healing. Zaleya pentandra, Cynodon dactylon, and Cuscuta reflexa also showed high CSI values, ranging between 3.46 and 3.73. In contrast, species such as Gamochaeta pensylvanica and Verbascum virgatum showed much lower CSI scores, ranging from 0.467 to 0.6.

These values indicate the extent to which specific plants are integrated into local medicinal and cultural practices. Plants with higher CSI values are often those that serve multiple therapeutic purposes, are used by a broad segment of the community, and have longstanding symbolic or ritual importance. Similar patterns are documented in global ethnobotanical literature. For instance, the CSI of Oryza sativa was 0.81, Poa annua scored 7.69, and Zea mays recorded 6.77 in other cultural contexts, demonstrating that CSI values vary significantly based on regional customs, availability, and socio-economic relevance [32–34]. The CSI thus complements other ethnobotanical indices by providing a multidimensional view of plant value within traditional health systems.

Family use value (FUV)

The FUV analysis provides insights into the relative importance of different plant families based on their traditional medicinal use, ecological presence, and cultural and economic contributions. Among the families recorded, Brassicaceae ranked the highest with an FUV of 0.57, reflecting its widespread application in food and health, particularly through species such as cabbage and mustard. Scrophulariaceae followed with a value of 0.43, underlining its recognized medicinal relevance in treating respiratory and inflammatory conditions. Other families, including Leguminaceae, Orbanchaceae, and Caesalpiniaceae, also demonstrated significant use values, indicating their active roles in local health practices (Fig. 6).

Fig. 6.

Family Use Value (FUV) of ethnomedicinal plant families in the study area

Interestingly, the Poaceae family displayed variable FUV scores1.26 and 0.3reflecting the diversity of species it encompasses and their multiple roles ranging from nutritional to therapeutic. These findings are consistent with broader ethnobotanical patterns, where plant families such as Brassicaceae are not only culturally significant due to their culinary use but also pharmacologically relevant [34, 35]. Similarly, the medicinal importance of Scrophulariaceae has been substantiated in other studies for its applications in traditional therapies. These FUV outcomes affirm the multifunctional role of certain plant families in human well-being, linking biodiversity with both subsistence and healthcare systems.

Jaccard index

To evaluate the overlap in ethnomedicinal knowledge between Hasilpur and other regions, the Jaccard index was calculated based on comparisons with 20 previously published studies spanning from 2007 to 2023 (Table 5). The index values ranged from 0.0 to 12.5, illustrating a spectrum of ethnobotanical similarity and divergence. The highest Jaccard index was observed in the Shakargadh area (12.5) [36], suggesting a strong resemblance in plant usage patterns, likely due to ecological and cultural proximity. Conversely, the lowest similarity (0.0) was noted in a study from Iran [37], reflecting considerable differences in plant use traditions, potentially driven by distinct ecological zones, cultural preferences, or documentation approaches.

Table 5.

Jaccard index analysis for species comparison

Author Citation	Study area, province	SY	TRSs	NPSU	NPDU	PPSU	PPDU	TSCBA	JI
Ismail et al. [38]	Lodhran	2010	89	6	3	9	6.74	3.37	7.56
Fatima et al. [50]	Yazman	2019	118	8	6	14	6.77	5.08	9.79
Khan et al. [40]	Azad Kashmir	2012	68	1	1	2	1.47	1.47	1.88
Wariss et al. [11]	Lal sohanra	2014	84	10	3	13	11.9	3.57	11.81
Azhar et al. [45]	Vehari	2022	21	1	1	2	4.76	4.76	3.44
Saeed et al. [46]	Multan	2014	44	3	1	4	6.81	2.27	4.93
Arshad et al. [47]	Sialkot	2012	48	3	4	7	6.25	8.33	8.75
Qureshi et al. [48]	Sargodha	2012	98	4	2	6	4.08	2.04	4.58
Hussain et al. [49]	Gujrat	2010	88	6	5	11	6.81	5.68	9.48
Fizza et al. [36]	Islamabad	2012	34	2	3	5	5.88	8.82	7.35
Hussain et al. [39]	Layyah	2015	78	11	6	17	14.1	7.69	17
Aslam et al. [51]	Rajanpur	2014	18	0	1	1	0.00	5.55	1.78
Srivastava et al. [41]	India	2012	135	0	0	0	0.00	0.00	0.00
Qureshi et al. [52]	Gilgit	2007	27	0	1	1	0.00	3.70	1.53
Hussain et al. [53]	Gilgit	2022	27	0	1	1	0.00	3.70	1.53
Anwer et al. [22]	Bahawalnagar	2020	81	5	5	10	6.17	6.17	10
Haider and Zhong [43]	Bahawalpur	2014	123	10	5	15	8.1	4.06	10.20
Altaf et al. [44]	Gujranwala	2019	97	3	5	8	3.09	5.15	6.25
Hu et al. [42]	Guanxi, China	2020	456	0	0	0	0.00	0.00	0.00

key: SY. study area, TRSS. Total number of reported species, NPSU. The number of plants with similar uses, NPDU. The number of plants with dissimilar uses, TSCBA. Total number of species common in both areas, PPSU. Percentage of plants with similar uses, PPDU. Percentage of plants with dissimilar uses, JI. Jaccard index.

Additionally, Layyah, Pakistan, showed the highest number of shared species (17) with Hasilpur [40], highlighting a close floristic and ethnomedical alignment, which may be attributed to similar agro-ecological and socio-cultural conditions. The percentage of species with similar uses ranged from 0% (Iran) to 14% (Shakargadh), while dissimilar uses ranged from 0 to 21.4%, with Shakargadh again recording the highest discrepancy [36]. These variations emphasize the dynamic, location-specific nature of ethnomedicinal knowledge, supporting the need for regionally focused documentation to capture both conserved and evolving practices.

Importantly, while many plants shared across regions are traditionally valued for their healing properties, caution must be exercised in their use. For instance, Calotropis procera and Datura metel, both cited in this and other ethnobotanical surveys, are known to possess toxic compounds. C. procera contains cardiac glycosides, which can induce nausea, vomiting, and arrhythmias, while D. metel is rich in tropane alkaloids, known to cause hallucinations, dry mouth, blurred vision, and seizures when improperly used. These pharmacological risks necessitate careful application and underscore the importance of integrating traditional knowledge with modern healthcare guidance.

Novelty index

Tehsil Hasilpur is rich in medicinal plant diversity and ethnobotanical knowledge, particularly valuable in addressing healthcare needs in remote areas. A comparison of the present findings with 20 ethnobotanical studies from Pakistan and neighboring regions revealed 39 plant species with novel or regionally distinctive uses, reflecting unique cultural practices and ecological adaptations.

For instance, Acacia ampliceps is traditionally underreported in ethnomedicine, but in Hasilpur, it is used for treating skin and digestive disorders and diabetes. Vachellia nilotica, though widely known, is used here as a remedy for dysentery, in addition to diabetes and fever. Aerva javanica and Albizia lebbeck were recorded for arthritis and eye diseases, respectivelyapplications seldom cited in earlier studies. Calotropis procera was noted for asthma and digestive ailments, expanding its commonly known uses. Capparis decidua and Cassia fistula were found helpful in blood purification and arthritis, uses rarely reported in the literature.

Several grasses like Cenchrus biflorus and C. ciliaris were locally employed for asthma, diuretic action, and kidney stone treatment. Chenopodium murale was used for ulcers and diarrhea, while Cistanche deserticola was reported for arthritis and cough for the first time in this region. Erigeron canadensis was applied for hemorrhage, and Cuscuta reflexa for paralysis and hair treatment. Cynodon dactylon showed extended use in eye and skin disorders.

Uncommon applications were also recorded for Dactyloctenium aegyptium (digestive issues), Datura metel (earache), Digera muricata and Emex spinosa (female disorders), and Eragrostis cilianensis (kidney stones). Gamochaeta pensylvanica and Physalis peruviana were both documented for diabetes and kidney stone treatment respectivelynovel contributions to their therapeutic profiles.

Leptochloa fusca and Launaea nudicaulis were used for liver disorders and arthritis. Leucaena leucocephala and Melilotus indicus were noted for female health and diuretic effects. Panicum antidotale was valued for blood purification. Persicaria lapathifolia showed entirely new uses in treating fever and digestive ailments, and Phalaris minor for dysentery. Prosopis cineraria extended its applications to asthma, and Rorippa sylvestris was used for urinary diseases and kidney stonesnovel local insights.

Further, Saccharum bengalense, Spergula arvensis, Suaeda nigra, Tribulus terrestris, and Zaleya pentandra were documented for treating constipation, diuretic issues, skin, and digestive disorders, and kidney stonesmany of which had not been previously reported in Pakistan. Verbascum virgatum and Vicia hirsuta were newly identified for asthma, cough, pain relief, and anti-inflammatory use. Lastly, Ziziphus jujuba and Z. nummularia added novel data on their use in asthma, constipation, diabetes, and inflammation.

These findings demonstrate the uniqueness of ethnomedicinal practices in Hasilpur, expanding the national phytotherapeutic landscape. The novel applications align with broader trends while contributing original insights to Pakistan’s traditional healing repertoire (see Fig. 7, Fig. S4), emphasizing the urgent need to document and preserve such localized knowledge before it fades.

Fig. 7.

Percentage Distribution of Ethnomedicinal Plant Usage in Treating Common Health Ailments in the study area(1:Acacia ampliceps, 2:Acacia nilotica, 3:Aerva javanica, 4:Albizia lebbeck, 5:Calotropis procera, 6:Capparis decidua, 7:Cassia fistula, 8:Cenchrus biflorus, 9:Cenchrus ciliaris 10:Chenopodium murale, 11:Cistanche deserticola, 12:Conyza canadensis, 13:Cuscuta reflexa, 14:Cynodon daclon, 15:Dactyloctenium aegyptium, 16:Datura metel, 17:Digera arvensis, 18:Emex spinosus, 19:Eragrostis cilianensis, 20:Gamochaeta pensylvanica, 21:Leptochloa fusca, 22:Launaea nudicaulis, 23:Leucaena leucocephala, 24:Melilotus parviflora, 25:Panicum antidotale, 26:Persicaria lapathifolia, 27:Phalaris minor, 28:Physalis peruviana, 29:Prosopis cineraria, 30:Rorippa sylvestris, 31:Saccharum bengalense, 32:Spergula arvensis, 33:Suaeda nigra, 34:Tribulus terrestris, 35:Verbascum virgatum, 36:Vicia hirsute, 37:Zaleya pentandra, 38:Ziziphus jujube,39: Ziziphus nummularia, A: skin disorder, B:digestive disorder, C:diabetes, D:cough, E:fever, F:dysentery, G:arthritis, H: kidney stone, I: eye disease, J: wound healing, K: pain killer, L: asthma, M: production and purification of blood, N: constipation, O: diuretic, P: urinary diseases, Q: diarrhea, R: ulcer, S: hemorrhahagee, T: paralysis, U: hair treatment, V: earache, W: female disorder, X: flu, Y: liver disorder, Z: anti-inflammatory)

Toxicological considerations of documented medicinal plants

While this study highlights the rich ethnomedicinal knowledge of Hasilpur tehsil, it is equally important to consider the potential toxicity of certain plants traditionally used for healing purposes. Several species documented here contain bioactive compounds known to cause adverse effects when consumed inappropriately or without expert supervision.

Calotropis procera (Aak), commonly used for arthritis, asthma, and digestive disorders, contains toxic cardiac glycosides such as calotropin. These compounds may induce nausea, vomiting, diarrhea, and serious cardiac arrhythmias, particularly when consumed in large doses or over extended periods. Datura metel, valued in traditional medicine for earache, cough, and wound healing, contains tropane alkaloids such as atropine, scopolamine, and hyoscyamine. These are potent neurotoxins, and misuse can lead to dry mouth, blurred vision, hallucinations, hyperthermia, seizures, and even death. Extreme caution is required in its handling and internal application. Physalis peruviana, newly reported here for treating kidney stones, has fruits and leaves that may contain solanine-like glycoalkaloids, especially when unripe. These compounds can cause gastrointestinal irritation, including nausea, abdominal cramps, and diarrhea. Cuscuta reflexa (Akas bail), a parasitic herb used for hair treatment and paralysis, is reported in literature to contain pyrrolizidine alkaloids, which are hepatotoxic and may pose a risk of cumulative liver damage if consumed over time.

Chenopodium murale, documented for treating digestive disorders and ulcers, contains saponins and oxalates. These can be irritating to the gastrointestinal tract and potentially toxic to livestock and humans in high doses. Cassia fistula (Amaltas), widely used for arthritis, constipation, and fever, possesses anthraquinones in its pods and pulp, which can act as powerful laxatives. Overuse may result in electrolyte imbalance, dehydration, or intestinal cramps. Tribulus terrestris, utilized for cough, kidney stones, and urinary issues, has shown hepatotoxic and hormonal side effects in some experimental animal studies. Excessive intake may affect liver function and androgenic balance.

These plants exemplify the critical need for integrating toxicological awareness with ethnobotanical knowledge. While local communities have employed these species effectively for generations, their bioactive profiles warrant careful usage, standardized dosages, and informed healthcare practices. We recommend awareness campaigns and training for traditional healers to ensure the safe use of these potent medicinal plants. Additionally, scientific validation of dosages and active compounds will help balance therapeutic benefits with potential risks.

Cultural interpretation and regional differences

The unique uses of plants in Hasilpur, as compared to other regions, reflect the area’s distinct cultural and environmental context. The identification of Vicia hirsuta as an anti-inflammatory and painkiller, for example, may be rooted in the specific ecological zones of Hasilpur, where this plant is more abundant. Additionally, the practice of using Emex spinosus leaves for treating female disorders suggests that local health practices are tailored to address specific community needs. The cultural significance of certain plants, such as Persicaria lapathifolia and Physalis peruviana, may also be influenced by the community’s historical and medicinal traditions, which prioritize the treatment of ailments like digestive disorders and kidney stones.

In comparison to other areas, the use of plants like Rorippa sylvestris and Verbascum virgatum for urinary diseases and asthma treatment represents a local variation in how common ailments are managed. This points to the importance of local knowledge in shaping medicinal plant use, based on factors such as plant availability, the ecological context, and cultural beliefs. These regional differences are essential for understanding how traditional healing systems evolve in relation to the environment and community needs, underlining the cultural richness and diversity of the ethnobotanical practices in Tehsil Hasilpur.

Environmental and public health implications

The results of this study carry significant implications for both environmental and public health issues in Tehsil Hasilpur. The abundance of medicinal plants and their widespread use in the local population provide an alternative source of healthcare, particularly in areas where modern medical facilities may be limited. However, the continued reliance on wild plant species raises concerns about their sustainability. Over-harvesting, without proper management, could lead to the depletion of these valuable resources. Therefore, sustainable harvesting practices and the promotion of medicinal plant cultivation should be prioritized to ensure the long-term availability of these plants for future generations.

Moreover, the wide use of plants for treating common ailments such as fever, digestive issues, kidney stones, and respiratory disorders emphasizes the pressing need for affordable and accessible healthcare solutions in the region. Integrating these traditional healing practices with modern medical treatments could offer more holistic health care, especially for rural populations. The data underscores the importance of preserving traditional knowledge and exploring the potential of these plants in the development of alternative therapeutic options, especially in resource-limited settings.

The environmental aspect of this study also highlights the need for conservation efforts to protect the biodiversity of the region’s flora. Many of the plants used in local medicine are endemic or found in specific ecological zones, making them particularly vulnerable to environmental degradation. Efforts to conserve these plants should include educating local communities about sustainable harvesting, as well as supporting the establishment of medicinal plant nurseries to cultivate these species [54, 55].

Conclusion

The exploration of ethnomedicinal flora in Tehsil Hasilpur provides valuable insights into the traditional knowledge of indigenous communities. The study, involving 421 participants from diverse age groups and genders, highlighted the socio-demographic aspects of informants. A total of 39 plant species from 19 families were identified, with a dominance of perennial plants. Preparation methods such as powder, juice, and decoction were common, aligning with existing literature. Quantitative data analysis, including Family Importance Value, Popular Therapeutic Use Value, and Informant Consensus Factor, revealed key plant families and therapeutic uses. Other indices like Plant Part Value, Relative Frequency Citation, and Fidelity Level offered deeper insights into the effectiveness of various plant components. Family Use Value emphasizes the ecological, economic, and cultural significance of plant families. Comparative analyses using the Jaccard and Novelty indices highlighted both similarities and unique aspects of Tehsil Hasilpur’s ethnomedicinal knowledge. The identification of novel plant uses underscores the richness of local knowledge, contributing to the documentation of ethnomedicinal practices. This study stresses the need to preserve and integrate traditional knowledge into modern healthcare strategies, providing a resource for future research, conservation, and sustainable plant use in the region.

Supplementary Information

Below is the link to the electronic supplementary material.

Author contributions

XW, TA, HQ, ZS: supervision, writing, methodology, research design, experimentation, data curation; HSE, DS, BA: validation, drafting, software, resource, statistical analysis; NYR, MAA: validation, software, writing, drafting, statistical analysis; FY, MMA: writing, statistical analysis, resource, software, validation. All authors have read and approved the final manuscript and declare that they have no competitive interest.

Funding

42401287(National Natural Science Foundation of China, 42401287).

22SHC003(Social Science Foundation of Jiangsu Province 22SHC003).

This work was supported by Deanship of Scientific Research, Vice Presidency for Graduate Studies and Scientific Research, King Faisal University, Saudi Arabia (KFU252769).

Data availability

The author confirms that all data generated or analyzed during this study are included in this published article.

Declarations

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.

Ethical approval

All participants provided informed consent prior to data collection. For illiterate respondents, consent was obtained verbally with the assistance and approval of legal guardians. No compensation was offered, and participants were fully debriefed regarding the purpose of the study and their rights. The study was conducted in accordance with the guidelines and regulations of the International Society of Ethnobiology (http://www.ethnobiology.net/).