# Ethnophytotherapy Practices for Wound Healing among Populations of District Haripur, KPK, Pakistan

Authors: Zeeshan Siddique; Ghulam Mujtaba Shah; Hiwa M. Ahmed; Sobia Nisa; Abdullah Khan; Muhammad Idrees; Shumaila Naz; Syed Waqas Hassan; Muhammad Mohiuddin
Journal: Evidence-Based Complementary and Alternative Medicine
 (2019)

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## Abstract

Wounds, burns, cuts, and scarring may cause a serious problem for human health if left untreated, and medicinal plants are identified as potentially useful for wound healing. Therefore, the study focused on ethnophytotherapy practices for wound healing from an unexplored area, Pakistan. Ethnophytotherapeutic information was collected through well-planned questionnaire and interview methods by targeting 80 informants (70 males and 10 females), in the study area. Data was analyzed through quantitative tools like use value (UV) and credibility level (CL). A total of forty wound healing plant species, belonging to twenty-nine families, were being used in forty-six recipes. Herbs constitute (35%), shrubs (30%), trees (30%), and climbers (5%) in the treatment of multiple human injuries. For remedies preparations, leaves were most frequently utilized (52%) followed by whole plant, flowers, twigs, roots, bulb, bark, rhizome, resin, oil, leaf gel, latex, gum, and creeper. The most form of herbal preparation was powder (34.7%) and poultice (32.6%), followed by decoction, bandaged and crushed, in which 40% internally and 60 % externally applied. The drugs from these plants seem to be widely used to cure wounds:Acacia modesta,Aloe barbadensis,Azadirachta indica,Ficus benghalensis,Nerium oleander, andOlea ferruginea with higher use values (0.75). Local people are still connected with ethnophytotherapies practices for curing wounds for several reasons. This ethnomedicine and the wound healing plants are under severe threats; thus conservation must be considered. Further research should be directed towards implementing pharmacological activity on these invaluable botanical drugs.


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## Body

## 1. Introduction

Plants as medicine play an important role in the public health sector across the world. Patients have been utilizing medicinal plants for a long time to fulfill different daily needs and to maintain well-being [1]. Plants provide people with food, medicines, and fodder for livestock, as well as materials for construction of houses [2]. The history of discovery and use of different medicinal plants is as old as the history of discovery and use of plants for food [3]. From the history, it was revealed that the ancient people used herbal medicine for treatment of various diseases including burn injury, due to its simplicity, low cost, and affordable basis [4]. Today, the injury is a serious health problem across the world, often associated with high-costs and inefficient therapies [5] and affect people both physically and psychologically [6]. It is estimated that several million patients suffer from wounds, burns, and cuts every year, which may result in death when they did not get treated properly [7, 8]. Wound infections and related diseases are very common in developing and some developed countries due to unhygienic conditions [9, 10]. Wounds can be referred to as physical disabilities [11] and are marked as injury to normal skin structural, anatomical, physiological, and functional variation [12]. World Health Organization (WHO) 2018 data estimated that 180 000 people died every year due to burn injuries, and the vast majority of these deaths occur in low- and middle-income countries. Many medical plants support natural repairing process of skin [13, 14]. As described in the different literature, 70% of the wound healing drugs are of plant origin, 20% of mineral origin, and the remaining 10% consisting of animal products [15].So, by keeping in view the importance of phytotherapies for wound healing, our study was conducted with the aims (i) to unveil the valuable wounds healing plants from District Haripur, KPK, Pakistan, as previously this area was unexplored in this regard, (ii) to record traditional folk knowledge and phytotherapies being used in wound healing practices, (iii) to record wound healing medicinal plants with highest use value (UV) and credibility level (CL) for further in vitro investigations, (iv) to identify potential threats, and (v) to provide baseline data for phytochemists, pharmacologists, and conservationists for further future study.


## 2. Methods

### 2.1. Study Area

Haripur district is situated in Hazara division of Khyber Pakhtunkhwa province of Pakistan (Figure1) at latitude 33°-44′ to 34°-22′ and longitude 72°-35′ to 73°-15′ and about 610 meters above the sea level. A total area of the district is 1725 square kilometers. Haripur was founded in 1822 by Hari singh Nalva, a Sikh General of Ranjit Singh’s army. He was the Governor of Kashmir in 1822-23 A.D. after whom it is named. District Haripur has three tehsils, namely, Khanpur, Ghazi, and Haripur. The whole district is subdivided into 45 Union Councils (UCs). According to National Institute of Population Studies (NIPS), the estimated population of the district was 857,000, in 2008, having population density of 497 persons per square kilometer. The district is predominantly a rural district where only 12% population lives in urban areas. Agriculture is the main source of livelihood of rural population of the district. Haripur district has distinct geographical significance as its boundaries touch Districts Mansehra, Abbottabad, Torghar, Buner, Swabi, Attock, Rawalpindi, and Federal capital Islamabad [16].Figure 1
Map of study area in Pakistan.


### 2.2. Field Survey

The whole study area was frequently visited and the main target sites in the study area were Khanpur, Garmthun, Najafpur, Dartian, Babotri, Baghpur dehri, Kohala, Nilan Bhoto, Jabri, Hattar, Kotnajibullah, Khalabat, Beer, Ghazi, Nara Amazai, etc. A field survey was aimed to collect field data and activities like (i) recording folk knowledge and phytotherapies being used in wound healing practices, (ii) plant’s collection, (iii) local information about plants, (iv) identification of potential threats, (v) photography, etc. This survey was completed through well-planned questionnaires, interviews, and keen observations. Questionnaire method was also helpful in the documentation of folk indigenous knowledge. The interviews were helpful in investigation of local people and knowledgeable persons (farmers and herdsmen), who are mainly connected with plants and involved in traditional health care. During the field visits, total of 80 informants were approached randomly for questionnaires and interviews. Their description with respect to age, education, profession, etc. is given in (Table1).Table 1
Demographic characteristics of participants.
By age 10-20 years 20-30 years 30-40 years 40-50 years 50-60 years Above 60 years % Male 0 05 10 15 18 22 87.5 % Female --- --- --- 03 04 03 12.5 % Total --- (6.2%) (12.5%) (22.5%) (27.5%) (31.2%) --- By qualification Illiterate Primary Middle Secondary Higher secondary Higher education % Male 16 18 14 14 06 02 87.5 % Female 05 03 02 --- --- --- 12.5 % Total (26.2%) (26.2%) (20%) (17.5%) (7.5%) (2.5%) --- By profession Farmers Herdsmen (nomadic) Hakeem Teachers Shop-keeper Laborers % Male 45 15 03 02 02 03 87.5 % Female 08 02 --- --- --- --- 12.5 % Total (66.2 % ) (21.2 % ) (3.7 % ) (2.5 % ) (2.5 % ) (3.7 % ) ---


### 2.3. Plant Collection and Identification

The plant specimens collected were authenticated using the international plant name index (http://www.ipni.org), the plant list (www.theplantlist.org), and GRIN taxonomy site (http://www.ars-grin.gov/cgi-bin/npgs/html/queries.pl). The life form of investigated plants was categorized into herbs, shrubs, grasses, and trees (annual, biennial, or perennial), according to the system modified by Brown [17]. The collected plant specimens were identified by Prof. Dr. Ghulam Mujtaba Shah (Plant Taxonomist), Hazara University Mansehra (Pakistan), and by using Flora of West Pakistan [18] and Flora of Punjab [19]. The voucher specimens were deposited in the Herbarium, Department of Botany, Hazara University, Mansehra (Pakistan).


### 2.4. Identification of Potential Threats

During field survey, potential threats were identified through well-planned questionnaires, interviews, and keen observations. Therefore, the data obtained were tabulated and supported by photography. The main aim of the photography was to support field data with evidence. Photography of study area, as well as important plants and potential threats, was taken.


### 2.5. Statistical Analysis

The ethnophytotherapeutic data was statistically analyzed using Microsoft Office Excel software (2010). The use value (UV) of plant species were also determined [1, 20].Use value (UV) determines the relative importance of uses of plant species. It is calculated using the following formula:(1)UVi=ƩUiNiwhere “UV” indicates use value of individual species, “U” is the number of uses recoded for that species, and “N” represents the number of informants who reported that species.Credibility level (CL) of plant species: to determine credibility level of plants, a simple statistical tool was developed given name “credibility level” (CL). First of all, those plants are chosen which were reported by more than five informants with the same use. Then each plant was evaluated under the following formula:(2)CL=NiƩNi×100where “CL” indicates credibility level of plant species, “N” is the number of informants recorded for this plant, and “ƩN” represents the total number of informants for all plant species. CL value of each plant was tabulated in ascending series. The higher CL value is the most credibility of the medical plant used as ethnomedicine among communities in the study area.


## 2.1. Study Area

Haripur district is situated in Hazara division of Khyber Pakhtunkhwa province of Pakistan (Figure1) at latitude 33°-44′ to 34°-22′ and longitude 72°-35′ to 73°-15′ and about 610 meters above the sea level. A total area of the district is 1725 square kilometers. Haripur was founded in 1822 by Hari singh Nalva, a Sikh General of Ranjit Singh’s army. He was the Governor of Kashmir in 1822-23 A.D. after whom it is named. District Haripur has three tehsils, namely, Khanpur, Ghazi, and Haripur. The whole district is subdivided into 45 Union Councils (UCs). According to National Institute of Population Studies (NIPS), the estimated population of the district was 857,000, in 2008, having population density of 497 persons per square kilometer. The district is predominantly a rural district where only 12% population lives in urban areas. Agriculture is the main source of livelihood of rural population of the district. Haripur district has distinct geographical significance as its boundaries touch Districts Mansehra, Abbottabad, Torghar, Buner, Swabi, Attock, Rawalpindi, and Federal capital Islamabad [16].Figure 1
Map of study area in Pakistan.


## 2.2. Field Survey

The whole study area was frequently visited and the main target sites in the study area were Khanpur, Garmthun, Najafpur, Dartian, Babotri, Baghpur dehri, Kohala, Nilan Bhoto, Jabri, Hattar, Kotnajibullah, Khalabat, Beer, Ghazi, Nara Amazai, etc. A field survey was aimed to collect field data and activities like (i) recording folk knowledge and phytotherapies being used in wound healing practices, (ii) plant’s collection, (iii) local information about plants, (iv) identification of potential threats, (v) photography, etc. This survey was completed through well-planned questionnaires, interviews, and keen observations. Questionnaire method was also helpful in the documentation of folk indigenous knowledge. The interviews were helpful in investigation of local people and knowledgeable persons (farmers and herdsmen), who are mainly connected with plants and involved in traditional health care. During the field visits, total of 80 informants were approached randomly for questionnaires and interviews. Their description with respect to age, education, profession, etc. is given in (Table1).Table 1
Demographic characteristics of participants.
By age 10-20 years 20-30 years 30-40 years 40-50 years 50-60 years Above 60 years % Male 0 05 10 15 18 22 87.5 % Female --- --- --- 03 04 03 12.5 % Total --- (6.2%) (12.5%) (22.5%) (27.5%) (31.2%) --- By qualification Illiterate Primary Middle Secondary Higher secondary Higher education % Male 16 18 14 14 06 02 87.5 % Female 05 03 02 --- --- --- 12.5 % Total (26.2%) (26.2%) (20%) (17.5%) (7.5%) (2.5%) --- By profession Farmers Herdsmen (nomadic) Hakeem Teachers Shop-keeper Laborers % Male 45 15 03 02 02 03 87.5 % Female 08 02 --- --- --- --- 12.5 % Total (66.2 % ) (21.2 % ) (3.7 % ) (2.5 % ) (2.5 % ) (3.7 % ) ---


## 2.3. Plant Collection and Identification

The plant specimens collected were authenticated using the international plant name index (http://www.ipni.org), the plant list (www.theplantlist.org), and GRIN taxonomy site (http://www.ars-grin.gov/cgi-bin/npgs/html/queries.pl). The life form of investigated plants was categorized into herbs, shrubs, grasses, and trees (annual, biennial, or perennial), according to the system modified by Brown [17]. The collected plant specimens were identified by Prof. Dr. Ghulam Mujtaba Shah (Plant Taxonomist), Hazara University Mansehra (Pakistan), and by using Flora of West Pakistan [18] and Flora of Punjab [19]. The voucher specimens were deposited in the Herbarium, Department of Botany, Hazara University, Mansehra (Pakistan).


## 2.4. Identification of Potential Threats

During field survey, potential threats were identified through well-planned questionnaires, interviews, and keen observations. Therefore, the data obtained were tabulated and supported by photography. The main aim of the photography was to support field data with evidence. Photography of study area, as well as important plants and potential threats, was taken.


## 2.5. Statistical Analysis

The ethnophytotherapeutic data was statistically analyzed using Microsoft Office Excel software (2010). The use value (UV) of plant species were also determined [1, 20].Use value (UV) determines the relative importance of uses of plant species. It is calculated using the following formula:(1)UVi=ƩUiNiwhere “UV” indicates use value of individual species, “U” is the number of uses recoded for that species, and “N” represents the number of informants who reported that species.Credibility level (CL) of plant species: to determine credibility level of plants, a simple statistical tool was developed given name “credibility level” (CL). First of all, those plants are chosen which were reported by more than five informants with the same use. Then each plant was evaluated under the following formula:(2)CL=NiƩNi×100where “CL” indicates credibility level of plant species, “N” is the number of informants recorded for this plant, and “ƩN” represents the total number of informants for all plant species. CL value of each plant was tabulated in ascending series. The higher CL value is the most credibility of the medical plant used as ethnomedicine among communities in the study area.


## 3. Results

During the present study, data on 40 medicinal plant species belonging to 29 families that are being used in wound healing phytotherapies were collected from the study area. From those, herbs (35%) were the most widely used by local patients to treat various injury problems in the study areas of Haripur, followed by shrubs (30%), trees (30%), and climber species (5%) in which there were (22.5%) annual and (77.5%) perennial plant species as shown in Figure2(a). Detailed information about each plant pertaining to the botanical name, voucher number, local name, family, habit, lifespan, locality, plant parts used, ethnophytotherapies, number of informants, etc. is listed in Table 2. People of District Haripur use different parts of the plants for wound healing phytotherapies as shown in Figure 2(b). Among those plant parts, leaves were the most frequently used (52%) followed by whole plant (10%), flowers (8%), twigs, roots, bulb and bark (4% each) and rhizome, resin, oil, leaf gel, latex, gum, and creeper (2% each).Table 2
Ethnophytotherapies for wounds healing in District Haripur.
No Botanical Name/Voucher No. Local Name Family Habit Life span Locality Part Used Ethno-Phytotherapies No. of informants U.V 1 Acacia modestaWall. 01-Z Phulai Leguminosae Tree Perennial Dartian Twigs, bark & leaves For gum bleedings: Twigs are used asmasvak. For mouth boils: Decoction of bark is gargled several times a day. For abscesses, boils & adulthood poxes: Half spoon powdered leaves are taken with water for a few days. 04 0.75  2 Acacia nilotica(L.) Delile 02-Z Kikar Leguminosae Tree Perennial Najafpur Flowers, leaves & gum Formouth ulcer:1/4th spoon of powdered flowers and leaves are taken with water in morning and evening. For stomach ulcer: 1/4th spoon of powdered gum is taken with milk or water. 04 0.5  3 Achyranthes aspera L. 03-Z Puth-Kanda, Lehndi booti Amaranthaceae Herb Perennial Khanpur Leaves For wound washing & healing: Decoction of leaves is used for washing the wounds and then poultice of leaves is applied. 05 0.4  4 Adhatoda vasicaNees 05-Z Bhaikur, aroosa Acanthaceae Shrub Perennial Halli Leaves For pimples: 1/2 cup of leaves juice is taken 2 times a day. For skin wounds: Powdered leaves are applied topically. 08 0.25  5 Allium cepaL. 08-Z Payaz Amaryllidaceae Herb Perrenial Khanpur Bulb For wound healing: Inner bulb scale is heated in mustard oil and bandaged on wounds. 02 0.5  6 Allium sativumL. 09-Z Thoom Amaryllidaceae Herb Annual Khanpur Bulb For animal and insect bites: Grinded in vinegar and made into a paste and applied. 08 0.12  7 Aloe vera(L.) Burm.f. 10-Z Kanwar-ghandal Xanthorrhoeaceae Herb Perennial Dara Leaf gel For burn, wounds and other skin problems: Gel of leaves is burnt over the fry pan and applied topically. 04 0.75  8 Althaea officinalisL. 11-Z Khatmi Malvaceae Herb Annual Halli Flowers & leaves For skin burns: Powdered flowers and leaves are applied. 04 0.25  9 Amaranthus viridisL. 12-Z Chaleray Amaranthaceae Herb Annual Jabri Leaves For healing of boils & abscesses: The upper surfaces of leaves are smeared with mustard oil, warmed gently and bandaged. 06 0.33  10 Azadirachta indicaA.Juss. 13-Z Nim Meliaceae Tree Perennial Bagla Leaves For skin pimples, boils & abscesses: Leaves are dipped in water at night. In morning one spoon of this water is taken. 04 0.75  11 Berberis lycium Royle14-Z Simbulu Berberidaceae Shrub Perennial Dartian Root For mouth boils & internal wounds:1/4th spoon of dried powdered root is taken with water. 10 0.2  12 Bombax ceibaL. 15-Z Sumbal Malvaceae Tree Perennial Daboola Stem bark For wound healing: Bark paste is applied topically. 02 0.5  13 Cannabis sativaL. 21-Z Pang, bhang Cannabaceae Sub shrub Annual Hattar Leaves For wounds: Leaves are bound over the wounds. 02 0.5  14 Cissampelos pareiraL. 22-Z Phalaan jarhi, Ghora-sum Menispermaceae Climer Perennial Najafpur Leaves For wounds & itching: Crushed leaves are applied. 06 0.3  15 Curcuma longaL. 31-Z Haldi Zingiberaceae Herb Perennial Khanpur Rhizome For internal wounds: One spoon of dried grounded rhizome is mixed in one cup of hot milk and taken at night. 07 0.14  16 Cuscuta reflexaRoxb.33-Z Bail Convolvulaceae Climber Perennial Najafpur Creepers For pimples & wounds: Creeper is crushed after boiling and tied over. 05 0.4  17 Cynodon dactylon(L.) Pers. 40-Z Khabal Poaceae Herb Perennial Nara Amazai Whole plant For nose and wound bleedings: Paste of whole plant is applied. 08 0.25  18 Dodonaea viscosa (L.) Jacq. 55-Z Sanatha Sapindaceae Shrub Perennial Garam Thoon Leaves For skin boils & wounds: Powdered leaves are applied. 13 0.15  19 Eucalyptus globulus Labill. 58-Z Gond Myrtaceae Tree Perennial Khanpur Oil For skin wounds & fungal infections: Massage of Eucalyptus oil is useful. 08 0.25  20 Ficus benghalensis L. 86-Z Bohr Moraceae Tree Perennial Bandi Leaves For pimples, acne & rashes: Paste of leaves is applied. 04 0.75  21 Ficus caricaL. 90-Z Anjeer Moraceae Tree Perennial Daboola Milky latex For wounds healing: Milky latex is applied twice a day. 05 0.2  22 Lantana camaraL. 106-Z --- Verbenaceae Shrub Perennial Hattar Leaves & twigs For wounds swelling: Decoction of leaves is applied. 02 0.5  23 Lawsonia inermisL. 109-Z Mehendi Lythraceae Tree Perennial Sarhadna Leaves For wounds: Leaf is grounded into paste and applied to get relief from burning sensation. 02 0.5  24 Malvastrum coromandelianum (L.) Garcke111-Z Dhamni boti Malvaceae Sub shrub Annual or biennial Najafpur Leaves For ringworms & wounds: Paste of leaves is applied. 03 0.66  25 Melia azedarachL.124-Z Daraik, bakain Meliaceae Tree Perennial Sarhadna Leaves For skin pimples: 1/2 cup of leaves juice is taken in morning. For burns: Fresh leaf extract is applied externally. 11 0.18  26 Mentha arvensisL.130-Z Podina Lamiaceae Herb Perennial Mankrai Leaves For insect bites wound: Leaves are grinded and bruised and applied topically. 08 0.12  27 Morus nigra L. 145-Z Kala toot, she-toot Moraceae Tree Perennial Dara Leaves For snake bite: Leaf extract is applied. 03 0.33  28 Nasturtium officinale R.Br. 150-Z Tara meera Brassicaceae Herb Perennial Khanpur Leaves For skin allergies & pimples:1/4th spoon of dried powdered leaves are taken with water daily. 03 0.66  29 Nerium oleanderL.162-Z Kundair Apocynaceae Shrub Perennial Najafpur Leaves & roots For scabies and skin swellings: Decoction of leaves is directly applied. For scorpion bite: Root paste is applied over the wound. 04 0.75  30 Ocimum basilicum L. 164-Z Niaz-bo Lamiaceae Herb Annual Khanpur Leaves For insect bite wounds: powdered leaves are rubbed. 03 0.33  31 Olea europaea subsp. cuspidata(Wall. & G.Don) Cif. 170-Z Kaho Oleaceae Tree Perennial Choi Leaves & twigs For skin boils and pimples: 1 cup of leaf tea is taken once in a day. For mouth boils: Young twigs are chewed under the teeth. 04 0.75  32 Rydingia limbata(Benth.) Scheen & V.A.Albert. 173-Z Chita kanda, bamboli Lamiaceae Shrub Perennial Najafpur Whole plant For wounds: Whole plant is powdered, mixed in butter and applied. 02 0.5  33 Oxalis corniculataL.178-Z Khat-matra Oxalidaceae Herb Annual Halli Leaves For skin inflammations: Powdered leaves are applied as a poultice. 04 0.25  34 Pinus roxburghii Sarg. 180-Z Chir Pinaceae Tree Perennial Muslimabad Resin For skin burns, boils & wounds: Resin is applied externally. 06 0.5  35 Punica granatumL. 195-Z Daruna Lythraceae Shrub Perennial Barkote Flowers For gum bleedings: Dried powdered flowers are used as tooth powder. 09 0.11  36 Rumex hastatus D. Don 206-Z Katmat, tehtur Polygonaceae Shrub Perennial Najafpur Leaves For wounds: Leaves paste is applied. 02 0.5  37 Solanum americanum Mill. Kach mach Solanaceae Herb Annual Joulian Whole plant For wound and boils: Whole plant paste is applied externally as a poultice. 05 0.4  38 Solanum surattense Burm. f. 240-Z Mohkree Solanaceae Herb Annual Khoi Kaman Whole plant For skin infection: Dried powdered plant is applied topically. 13 0.07  39 Woodfordia fruticosa(L.) Kurz. 256-Z Taawi, dhawi Lythraceae Shrub Perennial Najafpur Leaves For skin wounds: Poultice of leaves is applied externally. 06 0.16  40 Ziziphus nummularia(Burm.f.) Wight & Arn.282-Z Beri Rhamnaceae Shrub Perennial Sarahdna Leaves For wounds: Leaf paste is applied over the wounds. For mouth & gum bleedings: Leaves are boiled in water, and gargled several times a day. 05 0.4Figure 2
(a) Description of medicinal plants; (b) type of botanical parts; (c) methods of herbal drug preparation used for wound healing in the study area.
(a) (b) (c)The methods of preparation for 46 recorded recipes fall into 5 categories, viz., plant parts used as decoction/extract (21.7%), Grinded/powdered form (34.7%), paste/poultice (32.6%), crushed (4.3%), and bandaged (6.5%) as shown in Figure2(c).Study also revealed that local people use wound healing phytotherapies both internally and externally. These treatments involve 40% internal and 60 % external use. Use value (UV) of plant species was also calculated in order to determine the relative importance of plant in study area with respect to usage. Results showed thatAcacia modesta,Aloe barbadensis,Azadirachta indica,Ficus benghalensis,Nerium oleander, andOlea ferruginea have higher use values (UVs), i.e., 0.75, while speciesSolanum surattense,Punica granatum,Mentha arvensis, andAllium sativum have lower use values (UVs), i.e., 0.07, 0.11, 0.12, and 0.12, respectively, as shown in Table 2. CL value was also calculated to check the credibility of plants used in study area. CL values obtained are given in Table 3. The higher CL value is the most credibility of plant used as ethnomedicine among District Haripur communities. Results showed that 20 plants in study area are more credible in efficacy than others. Of these the highest CL value was recorded forDodonaea viscosa, i.e., 16.25; hence it is the most credible, in contrast toZiziphus nummularia which showed the lowest CL value i.e., 6.25, among these 20 plant species in study area.Table 3
Credibility level (CL) value for herbal drugs.
No Botanical Name Local Name Locality Part Used Used against C.L Values 1 Dodonaea viscosa (L.) Jacq. Sanatha Garam Thoon Leaves Skin boils & wounds 16.25 2 Solanum surattense Burm. f. Mohkree Khoi Kaman Whole plant Skin infection 16.25 3 Melia azedarachL. Daraik, bakain Sarhadna Leaves Skin pimples & burns 13.75 4 Berberis lyciumRoyle Simbulu Dartian Root Mouth boils & internal wounds 12.5 5 Punica granatumL. Daruna Barkote Flowers Gum bleedings 11.25 6 Adhatoda vasicaNees Bhaikur, aroosa Halli Leaves For pimples & skin wounds 10 7 Allium sativumL Thoom Khanpur Bulb Animal and insect bites 10 8 Cynodon dactylon(L.) Pers. Khabal Nara Amazai Whole plant Nose & wound bleedings 10 9 Eucalyptus globulus Labill. Gond Khanpur Oil Skin wounds & fungal infections 10 10 Mentha arvensisL. Podina Mankrai Leaves Insect bites wound 10 11 Curcuma longaL. Haldi Khanpur Rhizome Internal wounds 8.75 12 Amaranthus viridisL. Chaleray Jabri Leaves Healing of boils & abscesses 7.5 13 Cissampelos pareiraL. Phalaan jarhi, Ghora-sum Najafpur Leaves Wounds & itching 7.5 14 Pinus roxburghii Sarg. Chir Muslimabad Resin Skin burns, boils & wounds 7.5 15 Woodfordia fruticosa(L.) Kurz. Taawi, dhawi Najafpur Leaves Skin wounds 7.5 16 Achyranthes asperaL. Puth-Kanda, Lehndi booti Khanpur Leaves Wound washing & healing 6.25 17 Cuscuta reflexaRoxb Bail Najafpur Creepers Pimples & wounds 6.25 18 Ficus caricaL. Anjeer Daboola Milky latex Wounds healing 6.25 19 Solanum americanum Mill. Kach mach Joulian Whole plant Wound and boils 6.25 20 Ziziphus nummularia(Burm.f.) Wight & Arn. Beri Sarahdna Leaves Wounds and mouth & gum bleedings 6.25During the study, it was also explored that plant resources of District Haripur are under severe threats. The major threats identified were subsequent forest fires during the summer, over grazing (normal and nomadic), overexploitation, mining activities, etc. as shown in Table4. The important indigenous knowledge of plants is being confined to the older people mostly, as the young generations has little interest in such traditional practices and mainly because of transforming lifestyle and culture among the youth. This can be deduced from the informant’s description by age showing that there were only 6.2% informants below 30 years of age.Table 4
Major threats to the wound healing plants in the study area.
Locality/Threat Fire Over grazing (nomadic) Over exploitation (Cutting etc.) Mining activities Khanpur + + - + Garmthun + + + + Najafpur + + + + Dartian + + + + Babotri + + + - Baghpur dehri + + + + Kohala + + - + Nilan Bhoto - + + - Jabri + + + + Hattar + + - - Sarae Nehmat Khan - + - - Pharala - + + + Beer + + + - Ghazi - + - - Nara Amazai - + + -


## 4. Discussion

Since time immemorial, people have been used various parts of plants and its extracts in the treatment and prevention of many ailments [21]. This knowledge varies from region to region and from the community to community according to the presence of herbs and their historical uses [22]. In similar investigates, many other researchers [23–26] have significantly explored wound healing medicinal plants from other parts of the world. This is also confirmed by several other studies showing that herbs and plant organ leaves could be a major herbal remedy considered for many human ailments around the world including wounds and burns [27]. Many of these herbal medicines are used for wound healing in the form of (teas, decoctions, tinctures, syrups, oils, ointments, poultices, and infusions), as a safe and reliable natural substance derived from medicinal herbs [28].Comparative analysis shows that ethnophytotherapies for wound healings in District Haripur may or may not be similar in use with the other published literature reported from various other parts of the world. For example, present use of leaf juice ofMelia azedarachis used to cure pimples and burns, while Ahmad [29] reported that this plant is beneficial against scabies, carbuncles, and abscess in district Attock. In Indian traditional medicine, species of the following genera are commonly used to treat wound and related injuries;Abutilon,Achyranthes,Acorus,Aegle,Aerva,Aloe,Azadirachta,Bambusa,Bidens,Boerhaavia,Butea,Caesalpinia,Calotropis,Carissa,Cassia,Cucumis,Curcuma,Cynodon,Datura,Dodonaea,Eclipta,Euphorbia,Ficus,Hyptis,Lantana,Leucas,Morinda,Ocimum,Opuntia,Pavetta,Pergularia,Plumbago,Pongamia,Sida,Smilax,Terminalia,Tridax,Vitex, andZizyphus[30].Pistacia atlantica subsp.kurdica Zohary can be used externally to treat skin injury as well as internally for abdominal pain [31]. A review of the previously published literature shows that the most species display a range of pharmacological activities that are suggested to have wound healing potential. For example,Acacia modesta has anti-inflammatory properties [32].Ocimum basilicum holds antibacterial activity [33, 34].Berberis lyceum retains antifungal properties [35, 36]. In rats, methanolic extract ointment from leaves ofAdhatoda vasica had significant wound healing activity compared to standard drug [37]. A study by Ahmed [1] showed the importance ofAllium sativum for antidandruff, intestinal worms, blood circulation, rheumatism, stimulant, cancer, cholera, alopecia areata, tuberculosis, and plague in Kurdistan region of Iraq, while in our study the same species was used to treat wounds by insect. The same author reportedAlthaea officinalis to treat burns in the form of poultice, which is exactly similar to our results. This is due to that fact that there may be several factors playing a role in establishing knowledge of ethnobotany and ethnomedicine particularly in rural areas, such as phytogeographical and ecological characteristics, demographic and ethnic structure as well [28]. This comparative analysis strengthens the value of the wound healing knowledge from our study location for further future studies.


## 5. Conclusion

Plant extracts have been demonstrated as important potential herbal remedies in many traditional medicinal systems around the world for wound repair and tissue regeneration. People of District Haripur (study area) rely mainly on ethnophytotherapies for wound healing. This is because of traditional culture, easy availability, and cheaper source of herbal medicines. Local people have sufficient knowledge about wound healing practices and saved mostly by older informants. In the study area both the wound healing, medicinal plants, and folk traditional knowledge are getting depleted thus conservation is required to maintain this valuable natural resource. Further pharmacological studies are recommended to validate the current herbal traditional knowledge.



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*Source: 4591675-2019-07-14.xml*