Research ArticleEthnogynaecological Assessment of Medicinal Plants inPashtunrsquos Tribal Society

Muhammad Adnan1 Akash Tariq1 Sakina Mussarat1 Shaheen Begum2

Naser M AbdEIsalam3 and Riaz Ullah4

1Department of Botany Kohat University of Science and Technology Kohat 26000 Pakistan2Department of Environmental Sciences Fatima Jinnah Women University The Mall Rawalpindi Punjab 46000 Pakistan3Riyadh Community College King Saud University Riyadh 11437 Saudi Arabia4Department of Chemistry Government College Ara Khel Frontier Region Kohat 26000 Pakistan

Correspondence should be addressed to Akash Tariq akashmalik786yahoocom

Received 23 September 2014 Accepted 3 December 2014

Academic Editor Gail B Mahady

Copyright copy 2015 Muhammad Adnan et al This is an open access article distributed under the Creative Commons AttributionLicense which permits unrestricted use distribution and reproduction in any medium provided the original work is properlycited

The present study was designed to document detailed ethnogynaecological knowledge of selected remote regions of Pashtunrsquos tribein northwest Pakistan Semistructured questionnaires were designed to collect ethnogynaecological and ethnographic data Totalof 51 medicinal plants belonging to 36 families were documented that were used by the women of studied regions for the treatmentof 9 types of gynaecological complaints Majority of the plants (19) were found used against menses followed by 11 plants each forgonorrhea and pregnancy Bannu region has high number of gynaecological plants (22) followed by Karak (15) Women of theregions mostly used whole plants (33) and leaves (31) for various ethnomedicinal preparation of gynae Fic results showed thatall ailments in different areas scored high consensus ranges between 06 and 100 Majority of the female respondents (44) wereaged between 61 and 70 years of which most were illiterate Women in the remote regions of Pakistan have tremendous traditionalknowledge in utilizing medicinal plants for their reproductive health Plants with high Fic values should be cross-checked for theirin vitro and in vivo validation Young girls should be educated on the importance of ethnogynaecological practices to conserve thisvaluable knowledge

1 Introduction

Medicinal plants are always an essential part of human healthcare system because there are major concerns about syn-thetic drugsrsquo expensiveness side effects and toxicity WHOreported that almost three-fourths of the world populationrely on traditional medicines [1] In the present time it isvery much essential to find some alternative medicines forthe treatment of variety of ailments [2] More than 50 ofall modern clinical or allopathic drugs are of natural productorigin hence traditional medicines can play a vital role inthe pharmaceutical sciences [3] Pakistan is bestowed witha great diversity of medicinal plants Out of 6000 floweringplant species in Pakistan 600 species were reported for theirmedicinal uses [4]

Gynaecology is the medical treatment of female repro-ductive system (uterus vagina and ovaries) health Ethnogy-naecology is an emerging newbranch that basically deals withthe healing of ailments among tribal women for exampleabortion menstrual trouble leucorrhoea antifertility anddelivery problems [5] Sexual and reproductive health prob-lems account for 18 of the total global burden of diseaseand 32 of the burden among women of reproductive age[6] Women in the remote areas of Pakistan depend onthe plants for curing various diseases including abortionantifertility leucorrhoea and other menstrual troubles Theydo not go to doctor rather they depend on herbal treatmentas per the suggestions of old women or traditional healers[7] Rural women of Pakistan are frequently experiencinggynaecological problems and are more susceptible due to

Hindawi Publishing CorporationBioMed Research InternationalVolume 2015 Article ID 196475 9 pageshttpdxdoiorg1011552015196475

2 BioMed Research International

Afghanistan

Charikar

Jalalabad

Khyber Agency

Kabul

Gardeyz

Khowst

SharZarghun North

SouthWaziristan

Balochistan

WaziristanRazmak

Miranshah

Wana

Jandola

LakkiMarwat

Tank

Zhob

Dera IsmailKhan

DeraKhanIsmail

BannuKarak

HanguKurramAgency

ParachinarLandi

MohmandAgency

KotalOrakzai Agency

KohatKohat

Mianwali

Kalabagh

Panjab

Pakistan

Islamabad

Murree

India

BajaurAgency

DirDir

SwatShangla

Battagram

Mansehra

Mansehra

Chitral

Chitral

Mastuj

Mt Tirichmir Mor Khun

Northern Areas

Gilgit

AgencyMalakand

NowsheraCharsadda

Peshawar

Mardan Swabi

Buner

HaripurAbbottabad

Tajikistan

Kalam DasuKohistan

SaiduSharif

Naran

Figure 1 Map of the study area

poor standard of living famine and hard physical work evenduring their pregnancy Women locally known as ldquoDaiyardquohave tremendous traditional knowledge for the treatment ofthese diseases utilizing medicinal plants [8] However thisknowledge is decreasing rapidly as younger generation istaking least interest in learning these valuable practices andhealing techniques

In Pakistan there are very few studies conducted purelyon ethnogynaecology Literature is very scarce regardingtraditional medicines used by rural women for the treatmentof gynaecological disorders The present study was thereforedesigned to document traditional plants and their gynaeco-logical uses in the six major areas of Khyber PakhtunkhwaProvince Pakistan These regions are dominated by Pash-tunrsquos tribe and remote with poor infrastructure and lack ofmodern facilities People of the regions have low incomestatus and are suffering from high level of poverty [9ndash12]These factors force the locals to use traditional medicineand keep the indigenous knowledge intact The presentresearch was therefore designed with the aim to documentethnogynaecological knowledge of plant resources and toselect candidate plants for further in vitro investigationsThe present research would be a great contribution at both

national and international level for the use of traditionalplants against gynaecological problemsThe present researchwill provide baseline information for future research studiesregarding phytochemistry pharmacology and conservationof gynaecological plants

2 Materials and Methods

21 Study Area The present study was conducted in sixremote areas (Bannu Kohat Karak Malakand Mansehraand Chitral) of Khyber Pakhtunkhwa (KPK) Province Pak-istan (Figure 1) Bannu region is located in the south of KPKprovince and consists of 877Km2 area with a population of19593 [9] It lies between 32∘-43 and 33∘-06N latitude and 73∘-20 and 70∘-07E longitude Karak is situated in the south ofprovince with a total area of 600 km2 and lies between 70-40∘and 71-30∘N latitude and 32-48∘ and 33-23∘E longitude [10]Kohat is located at 33∘35101584013N 71∘26101584029E with an altitude of489m asl [13] Malakand is located in the north of KPKbetween 35∘10 and 35∘16N latitude and 71∘50 and 71∘83E lon-gitude [11] Chitral is the largest district of KPK province with14850 km2 area and lies between 35∘1510158400610158401015840 and 36∘5510158403210158401015840N

BioMed Research International 3

latitude and 71∘1110158403210158401015840 and 73∘5110158403410158401015840E longitude with a popu-lation of about 320000 [14] Mansehra is located at 34∘201015840N73∘121015840E of KPK a province Majority of the population inthe study regions are dominated by the Pashtunrsquos ethnicgroup All the regions are rural in nature and women ofthe regions are greatly dependent upon medicinal plants andforest resources for their primary health care need and forimproving their livelihood

22 Sampling and Data Collection Data of present study wasdocumented from January 2014 to June 2014 Prior to datacollection a brief group discussion was held with the rep-resentatives (Sherin Zaman Faiz Ullah Khan and NazirKhan) of communities locally known as ldquoMalikrdquo in order togain their consent to explain objectives of the researchstudy and to assure them protection of their traditionalknowledge The selection of informants was mainly based ontheir rich indigenous knowledge and long term experience ofutilization of plants Total of 300 female respondents wereselected in six regions with 50 informants in each area Lessnumber of informant selections in each area is due to thereason of cultural and religious restrictions of females Theselected respondents were local inhabitants of the regionsaged between 40 and 80 years Data was collected in the locallanguage of the respondents and then converted into EnglishSemistructured questionnaires were designed to collect eth-nomedicinal and ethnographic data The informants wereasked about the number of gynaecological plants known tothem their gynaecological applications and their parts usedEthnographic data about the age occupation and educationof the informants were also collected All the respondents andfocal persons of the study area provided permission to publishand protect the data on traditional medicines provided bythem

23 Specimen Collection and Identification Plants docu-mented by key respondents were collected from home gar-dens and natural vegetation during field surveyThe collectedvoucher specimens were taken to the Herbarium of KohatUniversity of Science and Technology (KUST) Kohat Pak-istan

Specimen identification and confirmation were under-taken by using Flora of Pakistan and taxonomic expertsSpecimens with their label were stored at the Herbarium ofKUST

24 Data Organization The collected data on ethnogy-naecological plants and ethnography of the respondentswas organized using Microsoft Excel 2007 and summarizedusing graphical statistical methods such as percentages Thehabit of the plants was categorized into 3 classes (herbsshrubs and trees) Reproduction of medicinal plants wasclassified into annual biennial and perennial Plant partswere classified into leaves roots stem whole plant seedsfruit and flower Gynaecological disorders were dividedinto 9 categories that is menses gonorrhea leucorrhoeaabortion pregnancy gynae abortifacient female impotencyand mastitis Ages of the respondents were categorized into

0

5

10

15

20

25

Bannu Karak Malakand Mansehra Chitral Kohat

Number of plantsNumber of gynaecological problems

Figure 2 Number of plants and gynaecological problems treated indifferent regions of Pakistan

four groups (40ndash50 51ndash60 61ndash70 and 71ndash80) Education ofthe female respondents was classified into 5 classes that isilliterate primary middle secondary and university level ofeducation Occupation of the females was divided into onlytwo classes (housewives and teachers)

25 Data Analysis

251 Informant Consensus Factor (Fic) Fic was used to forthe general uses of plants in different study areas and toindicate plants of particular interests Informantsrsquo consensusis the most preferred method to highlight widely used plantsfor a particular ailment and thus aids in the selection of plantsfor pharmacological and phytochemical studies [15] Prior tousing this method illnesses were classified into categoriesas high Fic plants are likely to be more pharmacologicallyactive in comparison with low Fic value plants [16] Fic valueslie between ldquo000 and 100rdquo Fic values are always greaterwhen single plant or few plants are used by large number ofinformants to cure a specific disorder while low Fic valuesgive an indication that informants do not agree over whichplant to use [17 18] The Fic can be calculated using theformula as follows

Fic = nur minus ntnur minus 1

(1)

where Fic = informants consensus factor nur = number of usecitation in each category and nt = number of species used

3 Results

The present study revealed that women of studied regionsused about 51 plants belonging to 36 families (Table 1) Bannuregion was found with high number of gynaecological plants(22) followed by Karak (15) Malakand (14) Mansehra (11)Chitral (10) and Kohat (8) Nine types of diseases weretreated in Bannu followed by eight in Karak (Figure 2)Women of the regions mostly used herbs (59) for thepreparation of ethnomedicines followed by trees (266)(Table 2) It was found that majority of the plants (78)were perennial in their mode of reproduction Women of the

4 BioMed Research International

Table1Ethn

omedicinalplantsused

totre

atgynecologicalproblem

s

Plantfam

ilies

Scientificn

amesvou

cher

no

Localn

ames

Habit

Reprod

uctio

nPartused

Region

Gyn

aecological

prob

lems

Acanthaceae

Justicia

adhatoda

LKU

H-810

Baikar

Shrub

Perenn

ial

Rootleaves

MalakandKa

rak

Bann

uGyn

aeabo

rtifa

cient

Amaranthaceae

Achyranthesa

speraLKU

H-811

Kurshaka

Herb

Perenn

ial

Who

leplant

KohatMalakand

Gon

orrhea

Anacardiaceae

Schinu

smolleLKU

H-812

Toor

maruch

Tree

Perenn

ial

Barkleaffruits

Bann

uMenses

Amaryllid

aceae

Alliu

msativ

umLKU

H-813

Thom

aHerb

Perenn

ial

Seeds

Karak

Menses

Alliu

mcepa

LKU

H-814

Thrashto

Herb

Perenn

ial

Bulb

Chitral

Gyn

aem

enses

Brassic

aceae

Brassicacampestr

isLKU

H-815

Sarson

Herb

Ann

ual

Leaves

MalakandKo

hat

Karak

Mastitis

Sisymbrium

irioLKU

H-816

Khelik

heli

Herb

Ann

ual

Seeds

ChitralK

arakB

annu

Pregnancy

Cann

abaceae

Cann

abissativaLKU

H-817

Bang

aHerb

Ann

ual

Leaves

andbark

Bann

uMalakand

Mansehra

Gon

orrheapregn

ancy

Cela

straceae

Gymnosporiaroyleana

Wallex

MAL

awsonKU

H-818

Pataki

Shrub

Perenn

ial

Seed

MansehraKa

rak

Pregnancy

Con

volvulaceae

Convolvulusa

rvensis

LKU

H-819

Pryvatay

Herb

Perenn

ial

Who

leplant

KarakBa

nnu

MalakandKo

hat

Menses

Cucurbita

ceae

Citru

lluscolocynthis(L)Schrad

KUH-820

Maraginyetr

uhHerb

Perenn

ial

Rootsa

ndfruits

Bann

uAb

ortifacientm

astitis

Cyperaceae

Cyperusrotun

dusL

KUH-821

Delloca

Herb

Perenn

ial

Who

leplant

Bann

uMenses

Equisetaceae

Equisetum

ramosissim

umDesf

KUH-822

Jorterhorse

tail

Herb

Perenn

ial

Who

leplant

Mansehra

Gon

orrhea

Fabaceae

Acaciafarnesiana

(L)Willd

KUH-823

Vilayatikikar

Tree

Perenn

ial

Gum

Kohat

Leucorrhoea

Acaciamodesta

WallKU

H-824

Palosa

Tree

Perenn

ial

Who

leplant

KohatKa

rakBa

nnu

Mansehra

Gon

orrheagyn

ae

Acacianilotica(L)Willdex

DelileKU

H-825

Kikar

Tree

Perenn

ial

Leavesbarkpo

dBa

nnuKa

rak

Mansehra

Gyn

aegon

orrhea

leucorrheafem

ale

impo

tency

Medica

gosativaLKU

H-826

Malkind

yeHerb

Perenn

ial

Leavesstem

Bann

uMenses

LotuscorniculatusL

KUH-827

Rub

Herb

Perenn

ial

Who

leplant

Chitral

Pregnancy

Hypericaceae

Hypericu

mperfo

ratum

LKU

H-828

Sheenchai

Herb

Perenn

ial

Fruitshoo

tMalakand

Menses

Juglandaceae

Jugla

nsregiaLKU

H-829

Ghu

zTree

Perenn

ial

Bark

KohatMansehra

Gyn

ae

Juncaceae

Juncus

thom

soniiB

uchenau

KUH-830

Gaw

agHerb

Perenn

ial

Who

leplant

Chitral

Pregnancy

Lamiaceae

Menthavirid

is(L)LKU

H-831

Podina

Herb

Perenn

ial

Leaves

Malakand

Menses

Thym

usserpyllum

LKU

H-832

Mervezei

Herb

Perenn

ial

Who

leplant

Bann

uMensesgynae

Malvaceae

Abelm

oschus

esculen

tus(L)

MoenchKU

H-833

Bhindi

Herb

Ann

ual

Fruits

Karak

Gon

orrhea

Abutilonindicum

(L)Sw

eet

KUH-834

Koso

beta

Shrub

Ann

ual

Who

leplant

Bann

uLeucorrhoeagynae

gono

rrheaabortio

nMalva

parvifloraLKU

H-835

Tikalai

Herb

Ann

ual

Leaves

Bann

uMenses

BioMed Research International 5

Table1Con

tinued

Plantfam

ilies

Scientificn

amesvou

cher

no

Localn

ames

Habit

Reprod

uctio

nPartused

Region

Gyn

aecological

prob

lems

Meliaceae

Meliaazadira

chta

LKU

H-836

Bakana

Tree

Perenn

ial

Barkfruits

gum

Bann

uKa

rak

Gon

orrhea

Myrtaceae

Eucalyptus

globu

lusL

abill

KUH-837

Lachi

Tree

Perenn

ial

Leavesoilste

mMalakand

Menses

Nyctaginaceae

Boerhaviacoccinea

Mill

KUH-838

Insutp

unara

Herb

Perenn

ial

Who

leplant

Malakand

Menses

Oleaceae

Olea

ferrugineaRo

yleK

UH-839

Khu

naTree

Perenn

ial

Fruits

leaves

Malakand

Menses

Fraxinus

xanthoxyloides(G

Don

)AD

CKU

H-840

Toor

Herb

Perenn

ial

Barkstemleaves

Chitral

Gyn

ae

Papaveraceae

Papaversom

nifer

umLKU

H-841

Posat

Herb

Ann

ual

Flow

erfruit

Mansehra

Abortifacientpregn

ancy

Plum

baginaceae

Plum

bago

zeylanica

LKU

H-842

Chmchip

attar

Shrub

Perenn

ial

Root

Mansehra

Abortifacient

Plantaginaceae

Veronica

agrestisL

KUH-843

Kho

sobeta

Herb

Ann

ual

Who

leplant

Bann

uMensespregnancy

Poaceae

Arun

dodona

xLKU

H-844

Herb

Perenn

ial

Stem

rhizome

Bann

uMenses

Desmostachya

bipinn

ata(L)

StapfK

UH-845

Gharc

hichon

aGrass

Perenn

ial

Who

leplant

Karak

Menses

Polygonaceae

Polyg

onum

biaristatum

Aitchamp

Hem

slKU

H-846

How

arSh

rub

Perenn

ial

Who

leplant

Bann

uGon

orrhea

Ranu

nculaceae

Aconitu

mheterophyllum

Wallex

RoyleK

UH-847

Patris

bhangdewana

sarbaw

ali

Herb

Perenn

ial

Latexroot

Mansehra

Gyn

ae

Rham

naceae

Zizip

husm

auritiana

Lam

KUH-848

Bera

Tree

Perenn

ial

Leavesbarkseeds

Bann

uGyn

ae

Rosaceae

Crataegussongaric

aK

Koch

KUH-849

Gho

nii

Tree

Perenn

ial

Leavesstembark

Chitral

Gyn

ae

Rubiaceae

Rand

iatetra

spermaBe

nthamp

Hoo

kfKU

H-850

Mainp

hal

Shrub

Perenn

ial

fruit

Chitral

Abortifacient

Rutaceae

Zanthoxylum

armatum

DC

KUH-851

Timbar

Tree

Perenn

ial

Fruitleaves

Mansehra

Abortifacient

Salicaceae

Salix

acmophylla

BoissK

UH-852

Chekar

Herb

Perenn

ial

Leavestwigs

Chitral

Menses

Saxifragaceae

Bergeniastracheyi(H

ookfamp

Thom

son)

EnglK

UH-853

Bisabu

rHerb

Perenn

ial

Leavesroo

tslatex

Chitral

Pregnancy

Solanaceae

Hyoscyamus

nigerL

KUH-854

Joligao

Herb

Biennial

Leaves

Chitral

Pregnancy

Solanu

msuratte

nseB

urmf

KUH-855

Manragh

onaym

ahok

riHerb

Biennial

Who

leplant

MalakandBa

nnu

Kohat

Gon

orrheapregn

ancy

With

aniacoagulan

s(Stocks)

Dun

alKU

H-856

Panirpanird

oda

Herb

Ann

ual

Fruits

KohatKa

rakBa

nnu

Leucorrhoea

With

aniasomnifer

a(L)Dun

alKU

H-857

Kotilaljanglip

aneer

Shrub

Perenn

ial

Who

leplant

MalakandMansehra

KarakBa

nnu

Leucorrheafem

ale

impo

tencymenses

DaturametelLKU

H-858

Barbaka

Shrub

Perenn

ial

Who

leplant

KarakBa

nnu

Gon

orrhea

Tamaricaceae

Tamarixaphylla

(L)HK

arst

KUH-859

Sheengh

azz

Tree

Perenn

ial

Leavesbark

KarakBa

nnu

Gyn

ae

Verbenaceae

Verbenaoffi

cinalisLKU

H-860

Koso

beeta

Herb

Perenn

ial

Who

leplant

Bann

uMalakand

Pregnancymenses

6 BioMed Research International

Table 2 General attributes of medicinal plants

Attribute Total number Percentage ()Part use

Leaves 16 313Whole plant 17 333Fruit 10 192Bark 6 115Root 5 96Stem 4 76Seed 4 76Flower 1 19

HabitHerb 31 59Shrub 7 134Trees 14 269

ReproductionAnnual 9 173Biennial 2 38Perennial 41 788

02468

101214161820

Num

ber o

f pla

nts

Abor

tion

Impo

tenc

y

Mas

titis

Leuc

orrh

oea

Abor

tifac

ient

Gyn

ae

Preg

nanc

y

Gon

orrh

ea

Men

ses

Gynaecological problems

Figure 3 Number of plants used to treat gynaecological problems

regions used different plant parts for the recipe preparationbut whole plant and leaves (33 and 31 resp) were foundto be the most frequent parts used against gynaecologicalcomplaints (Table 2) Nine types of gynaecological ailmentswere treated in study areas Majority of the plants (19) werefound to be used against menses followed by 11 plants eachfor gonorrhea and pregnancy related problems (Figure 3) Ficresults showed that all plants in different areas scored highconsensus ranges between 06 and 100 (Table 3) Majorityof the female respondents (44) were aged between 61 and70 years Total of 40 informants were illiterate followed by38 who had just primary level of education Majority of thefemales (86) interviewed were housewives followed by 14school teachers (Table 4)

4 Discussion

Present study results showed that women of studied remoteareas of Pakistan have strong traditional knowledge in theutilization of medicinal plants for variety of gynaecologi-cal disorders Traditionally the rural women prefer plantmedicines rather than modern medicine for their personalailments due to lack of modern facilities in the regionsAmong all studied regions Bannu was ranked first havinglarge number of gynaecological plants High number ofmedicinal plants in the region might be associated withthe prevalence of large number of gynaecological problemsin the Bannu region Nine types of ailments were foundtreated using ethnomedicines in Bannu region It is a waraffected region of Pakistan where traditional medicines useis a common practice [9] Karak and Malakand regions alsocontain considerable number of gynaecological plants due tothe greater plant diversity in the regions rural nature anddependency of women for their primary health care needs[11 19]

The women of the studied regions mostly use herbs(59) for the preparation of ethnomedicines followed bytrees (269) In most remote areas medicinal herbs arethe main ingredients of local medicines and consideredthe main lifeline and frequently first choice The highestuse of herbs gives an indication of the presence of greatabundance of herb species as noticed during field visits thatareas very close to houses were well covered with herbs andcenturies old traditional knowledge of the healers Commonuse of herbaceous plants has also been reported from otherregions of Pakistan [2 20] and parts of the world [21 22]Herbs can grow in variety of places like roadsides homegardens farmland wild habitats and foundmore common incomparison to other growth forms The highest tree speciesutilization might be associated with their potential to surviveeven during long dry seasons thus their abundance andavailability throughout the year is higher in arid and semiaridareas The findings are in line with some studies [10 23]while being contradictory with studies conducted elsewherewhere shrubs were more frequently used [24 25] Variationin medicinal plants growth form might be associated withdifferent sociocultural beliefs ecological status and variationin practices of traditional healers of different regions orcountries Women mostly use perennial plants (78) for thetreatment of gynaecological problems The reason behindusing perennial plants might be due to the fact that highnumber of herbs and trees in the studied regions are perennialin their reproduction status

Women of studied regions use reported medicinal plantsfor the treatment of nine types of gynaecological ailmentsMenses was found to be the most treated ailment in thestudied regions Total of 19 plants were used to treat mensesrelated problems followed by 11 plants each for gonorrhea andpregnancy 10 for gynae 6 for abortifacient 5 for leucorrheaand 2 plants each for mastitis and impotency and singleplant is used for abortion Higher plant utilization for mensesmight be due to natural phenomenon associated with varietyof complications such as abdominal or pelvic cramping

BioMed Research International 7

Table 3 Fic values of traditional medicinal plants for treating gynaecological problems in study regions

Gynaecological problems Bannu Karak Kohat Chitral Mansehra MalakandMenses 088 091 100 087 mdash 097Gonorrhea 091 093 083 mdash 092 092Mastitis 100 100 100 mdash mdash 100Pregnancy 094 081 mdash 090 072 072Leucorrhoea 091 096 082 mdash 092 100Abortion 100 mdash mdash mdash mdash mdashGynae 082 052 075 072 063 061Female impotency 091 093 mdash mdash 100 100

Table 4 Ethnographic data of study regions

Ethnographic characters Bannu Karak Malakand Chitral Mansehra Kohat PercentageAge groups

40ndash50 6 5 7 4 5 4 1051ndash60 15 12 13 12 10 10 2461ndash70 20 22 21 23 20 26 4471ndash80 9 11 9 11 15 10 22

EducationIlliterate 22 19 23 17 19 20 40Primary 18 22 20 14 19 19 38Middle 5 6 2 9 6 6 11Secondary 3 2 3 6 4 4 7University 2 1 2 4 2 1 4

OccupationHousewives 43 39 46 47 41 43 86Teachers 7 11 4 3 9 7 14

lower back pain bloating and sore breasts food cravingsmood swings and irritability headache and fatigue [2627] Different plants have been found effective in relievingmenses complications like Justicia adhatoda Schinus molleConvolvulus arvensis Cyperus rotundus and Hypericum per-foratum Rural women use different parts of plant to prepareethnomedicines however use of specific plant part dependsupon plant habit and user requirements Traditional healersmostly prefer leaves and whole plant for the formulation ofgynaecological recipes The selection of specific plant partssuggests that these parts have strong healing potential againstgynaecological disorders but these parts need phytochemicalscreening and pharmacological investigation in order tocross-check traditional knowledge Present findings are inline with other studies showing leaves and whole plants asthe most frequently used plant parts for the preparation ofdifferent ethnomedicines [21 22 28] Whole plant harvestingis considered a destructive type of harvesting and causespopulation reduction of plant species

Most of the plants were found used in more than oneregion for the same particular ailment for example Con-volvulus arvensis was used against menses complication inBannu Kohat Karak and Malakand Melia azadirachta wasfound to be effective against gonorrhea in Bannu and KarakSolanum surattense was being used against gonorrhea andpregnancy in Malakand Bannu and Kohat Such types of

resemblance using similar plants for the same type of ailmentsin different cultures or regions provide a strong signal ofbioactivity potential of the documented plant species Infor-mant consensus results showed high consensus values rangesbetween 06 and 100 for 9 disease categories in different areasHigh Fic values in these regions indicate high prevalence ofgiven gynaecological problems in these regions Accordingto Heinrich et al [17] high Fic values are very useful inthe selection of specific plants for further search of bioactivecompounds Most of the diseases were found to be treatedwith only one or two plants in the studied regions and theirFic score was also high 100 Such plants should furtherbe analyzed for their phytochemical and pharmacologicalinvestigation

Ethnographic data showed that majority of the females(44) interviewed were aged between 61 and 70 years Theseresults clearly indicate that traditional knowledge is restrictedto aged people in these regions due to least interest ofyounger generation Total of 40 informants were illiteratein these regions followed by 38 who had only primary levelof education Only 4 respondents had university level ofeducation which reflects the unavailability of standard edu-cational institutions in these areas Literate people had lessknowledge about medicinal plants as compared to illiteratepeople of the regions due to modernization and changing lifestyles Total of 86 women were housewives while only 14

8 BioMed Research International

of females were school teachers that might be due to the factthat in remote areas of Pakistan women are mostly confinedto homes due to variety of customs and religious restrictionsIn rural areas girls are supposed to be future wives mothersand housekeepers little attention is given to their formaleducation Rural women have little access to educationparticularly at higher levels Even at the primary and sec-ondary levels access is restricted retention rates are low andfacilities particularly in rural areas remain abysmal Womenare poorly represented in higher and technical education andthus have poor employment prospects The women do notget sufficient medical treatment due to unavailability of themedical facilities Low literacy rate lack of medical facilitiesand low income of the people are the main factors for theirgreater dependency on medicinal plants

5 Conclusions

The present study concluded that women in remote areasof Pakistan have great dependency on medicinal plants forthe treatment of different gynaecological problems Studiedregions contain considerable number of medicinal plantsused by the traditional healers in different herbal formu-lations Menses and gonorrhea were found to be the mostprevalent complications in the studied region Plants scoringhigh Fic value should be further evaluated for their phyto-chemical and pharmacological investigation Ethnogynaeco-logical knowledge is only restricted to aged women whileyoung generation is totally ignorant Young girls should beeducated regarding the importance of traditional knowledgeMoreover detailed studies on ethnogynaecological plantsshould be carried out before the extinction of this valuableknowledge

Conflict of Interests

The authors declare that there is no conflict of interestsregarding the publication of this paper

Authorsrsquo Contribution

Muhammad Adnan and Akash Tariq have designed theresearch project Akash Tariq Sakina Mussarat and ShaheenBegum conducted field work and collected ethnomedicinaldata After collection of data these authors analyzed the dataand prepared the whole paper Muhammad Adnan AkashTariq Riaz Ullah and Naser M AbdElsalam supervised allthe stages and provided comments on the draft All authorshave read and approved the final paper

Acknowledgments

The authors are thankful to the Deanship of Scientific Re-search King Saud University Riyadh Saudi Arabia for fund-ing the work through the Research Group Project no RGP-210 The authors offer special thanks to the local respondentsfor sharing their valuable knowledge

References

[1] B Sandhya S Thomas W Isabel and R Shenbagarathai ldquoEth-nomedical plants used by the Valaiyan community of Piran-malai Hills (Reserved Forest) Tamilnadu Indiamdasha pilot studyrdquoAfrican Journal of Traditional Complementary and AlternativeMedicines vol 3 no 1 pp 101ndash114 2006

[2] Z K Shinwari ldquoMedicinal plants research in Pakistanrdquo Journalof Medicinal Plant Research vol 4 pp 161ndash176 2010

[3] D C Deka V Kumar C Prasad et al ldquoOroxylum indicummdashamedicinal plant of North East India an overview of itsnutritional remedial and prophylactic propertiesrdquo Journal ofApplied Pharmaceutical Science vol 3 no 4 pp S104ndashS1122013

[4] E Nasir and S I Ali ldquoFlora of west Pakistanrdquo Tech Rep 1-190Pakistan Agriculture Research Council Islamabad Pakistan1971ndash1991

[5] A H M Rahman ldquoEthno-gynecological study of tradi-tional medicinal plants used by santals of Joypurhat DistrictBangladeshrdquo Biomedicine and Biotechnology vol 2 pp 10ndash132014

[6] C K Kaingu J A Oduma and T I Kanui ldquoPractices of tradi-tional birth attendants in Machakos District Kenyardquo Journal ofEthnopharmacology vol 137 no 1 pp 495ndash502 2011

[7] R A Qureshi M Ghufran S A Gilani A G Yousaf and ABatool ldquoIndigenous medicinal plants used by local women insouthern Himalayan regions of Pakistanrdquo Pakistan Journal ofBotany vol 41 no 1 pp 19ndash25 2009

[8] R B Tareen T Bibi M A Khan M Ahmad and M ZafarldquoIndigenous knowledge of folk medicine by the women of Kalatand Khuzdar regions of Balochistan Pakistanrdquo Pakistan Journalof Botany vol 42 no 3 pp 1465ndash1485 2010

[9] M Adnan I Ullah A Tariq et al ldquoEthnomedicine use in thewar affected region of northwest Pakistanrdquo Journal of Ethnobi-ology and Ethnomedicine vol 10 no 1 article 16 2014

[10] W Murad A Azizullah M Adnan et al ldquoEthnobotanicalassessment of plant resources of Banda Daud Shah DistrictKarak Pakistanrdquo Journal of Ethnobiology and Ethnomedicinevol 9 no 1 article 77 2013

[11] H ul HassanWMurad A Tariq andA Ahmad ldquoEthnoveteri-nary study of medicinal plants in Malakand Valley District Dir(Lower) Khyber Pakhtunkhwa Pakistanrdquo Irish Veterinary Jour-nal vol 67 article 6 2014

[12] I Ilahi ldquoEthnobotanical studies and problems associated withregeneration of herbals in kohat regionrdquo Pakistan Journal ofBotany vol 40 no 4 pp 1743ndash1753 2008

[13] S Shinwari R Qureshi and E Baydoun ldquoEthnobotanical studyof Kohat Pass (Pakistan)rdquo Pakistan Journal Botany vol 43 pp135ndash139 2011

[14] F Hadi A Razzaq A Rahman and A Rashid ldquoEthnobotanicalnotes onwoody plants of RechValley TorkhowDistrict ChitralHindu-Kush range Pakistanrdquo Scholarly Journal of AgriculturalScience vol 3 no 11 pp 468ndash472 2013

[15] M Giday T Teklehaymanot A Animut and Y MekonnenldquoMedicinal plants of the Shinasha Agew-awi and Amharapeoples in northwest Ethiopiardquo Journal of Ethnopharmacologyvol 110 no 3 pp 516ndash525 2007

[16] R T Trotter and M H Logan ldquoInformants consensus a newapproach for identifying potentially effective medicinal plantsrdquoin Plants in Indigenous Medicine and Diet N L Etkin Ed pp91ndash112 Redgrave Bedford Hill NY USA 1986

BioMed Research International 9

[17] M Heinrich A Ankli B Frei C Weimann and O SticherldquoMedicinal plants in Mexico healersrsquo consensus and culturalimportancerdquo Social Science and Medicine vol 47 no 11 pp1859ndash1871 1998

[18] M Canales T Hernandez J Caballero et al ldquoInformantconsensus factor and antibacterial activity of the medicinalplants used by the people of San Rafael Coxcatlan PueblaMexicordquo Journal of Ethnopharmacology vol 97 no 3 pp 429ndash439 2005

[19] MKhan andFHussain ldquoConservation status of plant species inTehsil Takht-eNasrati District Karak Khyber PakhtunKhawaPakistanrdquo International Journal of Biodiversity and Conserva-tion vol 5 pp 20ndash26 2013

[20] N Khan M Ahmed A Ahmed et al ldquoImportant medicinalplants of Chitral Gol National Park (CGNP) Pakistanrdquo PakistanJournal of Botany vol 43 no 2 pp 797ndash809 2011

[21] CMuthuM Ayyanar N Raja and S Ignacimuthu ldquoMedicinalplants used by traditional healers in Kancheepuram District ofTamil Nadu Indiardquo Journal of Ethnobiology and Ethnomedicinevol 2 article 43 2006

[22] C P Kala ldquoEthnomedicinal botany of the Apatani in theEasternHimalayan region of Indiardquo Journal of Ethnobiology andEthnomedicine vol 1 article 11 2005

[23] AMaroyi ldquoTraditional use of medicinal plants in south-centralZimbabwe review and perspectivesrdquo Journal of Ethnobiologyand Ethnomedicne vol 9 article 31 2011

[24] M J Moshi D F Otieno and A Weisheit ldquoEthnomedicine ofthe Kagera Region north western Tanzania Part 3 plants usedin traditional medicine in Kikuku village Muleba DistrictrdquoJournal of Ethnobiology and Ethnomedicine vol 8 article 142012

[25] S B Padal Y Vijayakumar R J Butchi and P ChandrasekharldquoEthnomedicinal uses of Shrub species by tribals of BorraPanchayat Ananthagiri Mandalam Visakhapatnam districtAndhra Pradesh Indiardquo International Journal of PharmaceuticalScience Invention vol 2 pp 10ndash12 2013

[26] P Sharma C Malhotra D K Taneja and R Saha ldquoProblemsrelated to menstruation amongst adolescent girlsrdquo Indian Jour-nal of Pediatrics vol 75 no 2 pp 125ndash129 2008

[27] K Yamamoto A Okazaki Y Sakamoto and M Funatsu ldquoTherelationship between premenstrual symptoms menstrual painirregular menstrual cycles and psychosocial stress amongJapanese college studentsrdquo Journal of Physiological Anthropol-ogy vol 28 no 3 pp 129ndash136 2009

[28] J A Bhat M Kumar and R W Bussmann ldquoEcological statusand traditional knowledge of medicinal plants in KedarnathWildlife Sanctuary of Garhwal Himalaya Indiardquo Journal ofEthnobiology and Ethnomedicine vol 9 no 1 article 1 2013

Submit your manuscripts athttpwwwhindawicom

Stem CellsInternational

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

MEDIATORSINFLAMMATION

of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Behavioural Neurology

EndocrinologyInternational Journal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Disease Markers

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

BioMed Research International

OncologyJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Oxidative Medicine and Cellular Longevity

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

PPAR Research

The Scientific World JournalHindawi Publishing Corporation httpwwwhindawicom Volume 2014

Immunology ResearchHindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Journal of

ObesityJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Computational and Mathematical Methods in Medicine

OphthalmologyJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Diabetes ResearchJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Research and TreatmentAIDS

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Gastroenterology Research and Practice

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Parkinsonrsquos Disease

Evidence-Based Complementary and Alternative Medicine

Volume 2014Hindawi Publishing Corporationhttpwwwhindawicom

2 BioMed Research International

Afghanistan

Charikar

Jalalabad

Khyber Agency

Kabul

Gardeyz

Khowst

SharZarghun North

SouthWaziristan

Balochistan

WaziristanRazmak

Miranshah

Wana

Jandola

LakkiMarwat

Tank

Zhob

Dera IsmailKhan

DeraKhanIsmail

BannuKarak

HanguKurramAgency

ParachinarLandi

MohmandAgency

KotalOrakzai Agency

KohatKohat

Mianwali

Kalabagh

Panjab

Pakistan

Islamabad

Murree

India

BajaurAgency

DirDir

SwatShangla

Battagram

Mansehra

Mansehra

Chitral

Chitral

Mastuj

Mt Tirichmir Mor Khun

Northern Areas

Gilgit

AgencyMalakand

NowsheraCharsadda

Peshawar

Mardan Swabi

Buner

HaripurAbbottabad

Tajikistan

Kalam DasuKohistan

SaiduSharif

Naran

Figure 1 Map of the study area

poor standard of living famine and hard physical work evenduring their pregnancy Women locally known as ldquoDaiyardquohave tremendous traditional knowledge for the treatment ofthese diseases utilizing medicinal plants [8] However thisknowledge is decreasing rapidly as younger generation istaking least interest in learning these valuable practices andhealing techniques

In Pakistan there are very few studies conducted purelyon ethnogynaecology Literature is very scarce regardingtraditional medicines used by rural women for the treatmentof gynaecological disorders The present study was thereforedesigned to document traditional plants and their gynaeco-logical uses in the six major areas of Khyber PakhtunkhwaProvince Pakistan These regions are dominated by Pash-tunrsquos tribe and remote with poor infrastructure and lack ofmodern facilities People of the regions have low incomestatus and are suffering from high level of poverty [9ndash12]These factors force the locals to use traditional medicineand keep the indigenous knowledge intact The presentresearch was therefore designed with the aim to documentethnogynaecological knowledge of plant resources and toselect candidate plants for further in vitro investigationsThe present research would be a great contribution at both

national and international level for the use of traditionalplants against gynaecological problemsThe present researchwill provide baseline information for future research studiesregarding phytochemistry pharmacology and conservationof gynaecological plants

2 Materials and Methods

21 Study Area The present study was conducted in sixremote areas (Bannu Kohat Karak Malakand Mansehraand Chitral) of Khyber Pakhtunkhwa (KPK) Province Pak-istan (Figure 1) Bannu region is located in the south of KPKprovince and consists of 877Km2 area with a population of19593 [9] It lies between 32∘-43 and 33∘-06N latitude and 73∘-20 and 70∘-07E longitude Karak is situated in the south ofprovince with a total area of 600 km2 and lies between 70-40∘and 71-30∘N latitude and 32-48∘ and 33-23∘E longitude [10]Kohat is located at 33∘35101584013N 71∘26101584029E with an altitude of489m asl [13] Malakand is located in the north of KPKbetween 35∘10 and 35∘16N latitude and 71∘50 and 71∘83E lon-gitude [11] Chitral is the largest district of KPK province with14850 km2 area and lies between 35∘1510158400610158401015840 and 36∘5510158403210158401015840N

BioMed Research International 3

latitude and 71∘1110158403210158401015840 and 73∘5110158403410158401015840E longitude with a popu-lation of about 320000 [14] Mansehra is located at 34∘201015840N73∘121015840E of KPK a province Majority of the population inthe study regions are dominated by the Pashtunrsquos ethnicgroup All the regions are rural in nature and women ofthe regions are greatly dependent upon medicinal plants andforest resources for their primary health care need and forimproving their livelihood

22 Sampling and Data Collection Data of present study wasdocumented from January 2014 to June 2014 Prior to datacollection a brief group discussion was held with the rep-resentatives (Sherin Zaman Faiz Ullah Khan and NazirKhan) of communities locally known as ldquoMalikrdquo in order togain their consent to explain objectives of the researchstudy and to assure them protection of their traditionalknowledge The selection of informants was mainly based ontheir rich indigenous knowledge and long term experience ofutilization of plants Total of 300 female respondents wereselected in six regions with 50 informants in each area Lessnumber of informant selections in each area is due to thereason of cultural and religious restrictions of females Theselected respondents were local inhabitants of the regionsaged between 40 and 80 years Data was collected in the locallanguage of the respondents and then converted into EnglishSemistructured questionnaires were designed to collect eth-nomedicinal and ethnographic data The informants wereasked about the number of gynaecological plants known tothem their gynaecological applications and their parts usedEthnographic data about the age occupation and educationof the informants were also collected All the respondents andfocal persons of the study area provided permission to publishand protect the data on traditional medicines provided bythem

23 Specimen Collection and Identification Plants docu-mented by key respondents were collected from home gar-dens and natural vegetation during field surveyThe collectedvoucher specimens were taken to the Herbarium of KohatUniversity of Science and Technology (KUST) Kohat Pak-istan

Specimen identification and confirmation were under-taken by using Flora of Pakistan and taxonomic expertsSpecimens with their label were stored at the Herbarium ofKUST

24 Data Organization The collected data on ethnogy-naecological plants and ethnography of the respondentswas organized using Microsoft Excel 2007 and summarizedusing graphical statistical methods such as percentages Thehabit of the plants was categorized into 3 classes (herbsshrubs and trees) Reproduction of medicinal plants wasclassified into annual biennial and perennial Plant partswere classified into leaves roots stem whole plant seedsfruit and flower Gynaecological disorders were dividedinto 9 categories that is menses gonorrhea leucorrhoeaabortion pregnancy gynae abortifacient female impotencyand mastitis Ages of the respondents were categorized into

0

5

10

15

20

25

Bannu Karak Malakand Mansehra Chitral Kohat

Number of plantsNumber of gynaecological problems

Figure 2 Number of plants and gynaecological problems treated indifferent regions of Pakistan

four groups (40ndash50 51ndash60 61ndash70 and 71ndash80) Education ofthe female respondents was classified into 5 classes that isilliterate primary middle secondary and university level ofeducation Occupation of the females was divided into onlytwo classes (housewives and teachers)

25 Data Analysis

251 Informant Consensus Factor (Fic) Fic was used to forthe general uses of plants in different study areas and toindicate plants of particular interests Informantsrsquo consensusis the most preferred method to highlight widely used plantsfor a particular ailment and thus aids in the selection of plantsfor pharmacological and phytochemical studies [15] Prior tousing this method illnesses were classified into categoriesas high Fic plants are likely to be more pharmacologicallyactive in comparison with low Fic value plants [16] Fic valueslie between ldquo000 and 100rdquo Fic values are always greaterwhen single plant or few plants are used by large number ofinformants to cure a specific disorder while low Fic valuesgive an indication that informants do not agree over whichplant to use [17 18] The Fic can be calculated using theformula as follows

Fic = nur minus ntnur minus 1

(1)

where Fic = informants consensus factor nur = number of usecitation in each category and nt = number of species used

3 Results

The present study revealed that women of studied regionsused about 51 plants belonging to 36 families (Table 1) Bannuregion was found with high number of gynaecological plants(22) followed by Karak (15) Malakand (14) Mansehra (11)Chitral (10) and Kohat (8) Nine types of diseases weretreated in Bannu followed by eight in Karak (Figure 2)Women of the regions mostly used herbs (59) for thepreparation of ethnomedicines followed by trees (266)(Table 2) It was found that majority of the plants (78)were perennial in their mode of reproduction Women of the

4 BioMed Research International

Table1Ethn

omedicinalplantsused

totre

atgynecologicalproblem

s

Plantfam

ilies

Scientificn

amesvou

cher

no

Localn

ames

Habit

Reprod

uctio

nPartused

Region

Gyn

aecological

prob

lems

Acanthaceae

Justicia

adhatoda

LKU

H-810

Baikar

Shrub

Perenn

ial

Rootleaves

MalakandKa

rak

Bann

uGyn

aeabo

rtifa

cient

Amaranthaceae

Achyranthesa

speraLKU

H-811

Kurshaka

Herb

Perenn

ial

Who

leplant

KohatMalakand

Gon

orrhea

Anacardiaceae

Schinu

smolleLKU

H-812

Toor

maruch

Tree

Perenn

ial

Barkleaffruits

Bann

uMenses

Amaryllid

aceae

Alliu

msativ

umLKU

H-813

Thom

aHerb

Perenn

ial

Seeds

Karak

Menses

Alliu

mcepa

LKU

H-814

Thrashto

Herb

Perenn

ial

Bulb

Chitral

Gyn

aem

enses

Brassic

aceae

Brassicacampestr

isLKU

H-815

Sarson

Herb

Ann

ual

Leaves

MalakandKo

hat

Karak

Mastitis

Sisymbrium

irioLKU

H-816

Khelik

heli

Herb

Ann

ual

Seeds

ChitralK

arakB

annu

Pregnancy

Cann

abaceae

Cann

abissativaLKU

H-817

Bang

aHerb

Ann

ual

Leaves

andbark

Bann

uMalakand

Mansehra

Gon

orrheapregn

ancy

Cela

straceae

Gymnosporiaroyleana

Wallex

MAL

awsonKU

H-818

Pataki

Shrub

Perenn

ial

Seed

MansehraKa

rak

Pregnancy

Con

volvulaceae

Convolvulusa

rvensis

LKU

H-819

Pryvatay

Herb

Perenn

ial

Who

leplant

KarakBa

nnu

MalakandKo

hat

Menses

Cucurbita

ceae

Citru

lluscolocynthis(L)Schrad

KUH-820

Maraginyetr

uhHerb

Perenn

ial

Rootsa

ndfruits

Bann

uAb

ortifacientm

astitis

Cyperaceae

Cyperusrotun

dusL

KUH-821

Delloca

Herb

Perenn

ial

Who

leplant

Bann

uMenses

Equisetaceae

Equisetum

ramosissim

umDesf

KUH-822

Jorterhorse

tail

Herb

Perenn

ial

Who

leplant

Mansehra

Gon

orrhea

Fabaceae

Acaciafarnesiana

(L)Willd

KUH-823

Vilayatikikar

Tree

Perenn

ial

Gum

Kohat

Leucorrhoea

Acaciamodesta

WallKU

H-824

Palosa

Tree

Perenn

ial

Who

leplant

KohatKa

rakBa

nnu

Mansehra

Gon

orrheagyn

ae

Acacianilotica(L)Willdex

DelileKU

H-825

Kikar

Tree

Perenn

ial

Leavesbarkpo

dBa

nnuKa

rak

Mansehra

Gyn

aegon

orrhea

leucorrheafem

ale

impo

tency

Medica

gosativaLKU

H-826

Malkind

yeHerb

Perenn

ial

Leavesstem

Bann

uMenses

LotuscorniculatusL

KUH-827

Rub

Herb

Perenn

ial

Who

leplant

Chitral

Pregnancy

Hypericaceae

Hypericu

mperfo

ratum

LKU

H-828

Sheenchai

Herb

Perenn

ial

Fruitshoo

tMalakand

Menses

Juglandaceae

Jugla

nsregiaLKU

H-829

Ghu

zTree

Perenn

ial

Bark

KohatMansehra

Gyn

ae

Juncaceae

Juncus

thom

soniiB

uchenau

KUH-830

Gaw

agHerb

Perenn

ial

Who

leplant

Chitral

Pregnancy

Lamiaceae

Menthavirid

is(L)LKU

H-831

Podina

Herb

Perenn

ial

Leaves

Malakand

Menses

Thym

usserpyllum

LKU

H-832

Mervezei

Herb

Perenn

ial

Who

leplant

Bann

uMensesgynae

Malvaceae

Abelm

oschus

esculen

tus(L)

MoenchKU

H-833

Bhindi

Herb

Ann

ual

Fruits

Karak

Gon

orrhea

Abutilonindicum

(L)Sw

eet

KUH-834

Koso

beta

Shrub

Ann

ual

Who

leplant

Bann

uLeucorrhoeagynae

gono

rrheaabortio

nMalva

parvifloraLKU

H-835

Tikalai

Herb

Ann

ual

Leaves

Bann

uMenses

BioMed Research International 5

Table1Con

tinued

Plantfam

ilies

Scientificn

amesvou

cher

no

Localn

ames

Habit

Reprod

uctio

nPartused

Region

Gyn

aecological

prob

lems

Meliaceae

Meliaazadira

chta

LKU

H-836

Bakana

Tree

Perenn

ial

Barkfruits

gum

Bann

uKa

rak

Gon

orrhea

Myrtaceae

Eucalyptus

globu

lusL

abill

KUH-837

Lachi

Tree

Perenn

ial

Leavesoilste

mMalakand

Menses

Nyctaginaceae

Boerhaviacoccinea

Mill

KUH-838

Insutp

unara

Herb

Perenn

ial

Who

leplant

Malakand

Menses

Oleaceae

Olea

ferrugineaRo

yleK

UH-839

Khu

naTree

Perenn

ial

Fruits

leaves

Malakand

Menses

Fraxinus

xanthoxyloides(G

Don

)AD

CKU

H-840

Toor

Herb

Perenn

ial

Barkstemleaves

Chitral

Gyn

ae

Papaveraceae

Papaversom

nifer

umLKU

H-841

Posat

Herb

Ann

ual

Flow

erfruit

Mansehra

Abortifacientpregn

ancy

Plum

baginaceae

Plum

bago

zeylanica

LKU

H-842

Chmchip

attar

Shrub

Perenn

ial

Root

Mansehra

Abortifacient

Plantaginaceae

Veronica

agrestisL

KUH-843

Kho

sobeta

Herb

Ann

ual

Who

leplant

Bann

uMensespregnancy

Poaceae

Arun

dodona

xLKU

H-844

Herb

Perenn

ial

Stem

rhizome

Bann

uMenses

Desmostachya

bipinn

ata(L)

StapfK

UH-845

Gharc

hichon

aGrass

Perenn

ial

Who

leplant

Karak

Menses

Polygonaceae

Polyg

onum

biaristatum

Aitchamp

Hem

slKU

H-846

How

arSh

rub

Perenn

ial

Who

leplant

Bann

uGon

orrhea

Ranu

nculaceae

Aconitu

mheterophyllum

Wallex

RoyleK

UH-847

Patris

bhangdewana

sarbaw

ali

Herb

Perenn

ial

Latexroot

Mansehra

Gyn

ae

Rham

naceae

Zizip

husm

auritiana

Lam

KUH-848

Bera

Tree

Perenn

ial

Leavesbarkseeds

Bann

uGyn

ae

Rosaceae

Crataegussongaric

aK

Koch

KUH-849

Gho

nii

Tree

Perenn

ial

Leavesstembark

Chitral

Gyn

ae

Rubiaceae

Rand

iatetra

spermaBe

nthamp

Hoo

kfKU

H-850

Mainp

hal

Shrub

Perenn

ial

fruit

Chitral

Abortifacient

Rutaceae

Zanthoxylum

armatum

DC

KUH-851

Timbar

Tree

Perenn

ial

Fruitleaves

Mansehra

Abortifacient

Salicaceae

Salix

acmophylla

BoissK

UH-852

Chekar

Herb

Perenn

ial

Leavestwigs

Chitral

Menses

Saxifragaceae

Bergeniastracheyi(H

ookfamp

Thom

son)

EnglK

UH-853

Bisabu

rHerb

Perenn

ial

Leavesroo

tslatex

Chitral

Pregnancy

Solanaceae

Hyoscyamus

nigerL

KUH-854

Joligao

Herb

Biennial

Leaves

Chitral

Pregnancy

Solanu

msuratte

nseB

urmf

KUH-855

Manragh

onaym

ahok

riHerb

Biennial

Who

leplant

MalakandBa

nnu

Kohat

Gon

orrheapregn

ancy

With

aniacoagulan

s(Stocks)

Dun

alKU

H-856

Panirpanird

oda

Herb

Ann

ual

Fruits

KohatKa

rakBa

nnu

Leucorrhoea

With

aniasomnifer

a(L)Dun

alKU

H-857

Kotilaljanglip

aneer

Shrub

Perenn

ial

Who

leplant

MalakandMansehra

KarakBa

nnu

Leucorrheafem

ale

impo

tencymenses

DaturametelLKU

H-858

Barbaka

Shrub

Perenn

ial

Who

leplant

KarakBa

nnu

Gon

orrhea

Tamaricaceae

Tamarixaphylla

(L)HK

arst

KUH-859

Sheengh

azz

Tree

Perenn

ial

Leavesbark

KarakBa

nnu

Gyn

ae

Verbenaceae

Verbenaoffi

cinalisLKU

H-860

Koso

beeta

Herb

Perenn

ial

Who

leplant

Bann

uMalakand

Pregnancymenses

6 BioMed Research International

Table 2 General attributes of medicinal plants

Attribute Total number Percentage ()Part use

Leaves 16 313Whole plant 17 333Fruit 10 192Bark 6 115Root 5 96Stem 4 76Seed 4 76Flower 1 19

HabitHerb 31 59Shrub 7 134Trees 14 269

ReproductionAnnual 9 173Biennial 2 38Perennial 41 788

02468

101214161820

Num

ber o

f pla

nts

Abor

tion

Impo

tenc

y

Mas

titis

Leuc

orrh

oea

Abor

tifac

ient

Gyn

ae

Preg

nanc

y

Gon

orrh

ea

Men

ses

Gynaecological problems

Figure 3 Number of plants used to treat gynaecological problems

regions used different plant parts for the recipe preparationbut whole plant and leaves (33 and 31 resp) were foundto be the most frequent parts used against gynaecologicalcomplaints (Table 2) Nine types of gynaecological ailmentswere treated in study areas Majority of the plants (19) werefound to be used against menses followed by 11 plants eachfor gonorrhea and pregnancy related problems (Figure 3) Ficresults showed that all plants in different areas scored highconsensus ranges between 06 and 100 (Table 3) Majorityof the female respondents (44) were aged between 61 and70 years Total of 40 informants were illiterate followed by38 who had just primary level of education Majority of thefemales (86) interviewed were housewives followed by 14school teachers (Table 4)

4 Discussion

Present study results showed that women of studied remoteareas of Pakistan have strong traditional knowledge in theutilization of medicinal plants for variety of gynaecologi-cal disorders Traditionally the rural women prefer plantmedicines rather than modern medicine for their personalailments due to lack of modern facilities in the regionsAmong all studied regions Bannu was ranked first havinglarge number of gynaecological plants High number ofmedicinal plants in the region might be associated withthe prevalence of large number of gynaecological problemsin the Bannu region Nine types of ailments were foundtreated using ethnomedicines in Bannu region It is a waraffected region of Pakistan where traditional medicines useis a common practice [9] Karak and Malakand regions alsocontain considerable number of gynaecological plants due tothe greater plant diversity in the regions rural nature anddependency of women for their primary health care needs[11 19]

The women of the studied regions mostly use herbs(59) for the preparation of ethnomedicines followed bytrees (269) In most remote areas medicinal herbs arethe main ingredients of local medicines and consideredthe main lifeline and frequently first choice The highestuse of herbs gives an indication of the presence of greatabundance of herb species as noticed during field visits thatareas very close to houses were well covered with herbs andcenturies old traditional knowledge of the healers Commonuse of herbaceous plants has also been reported from otherregions of Pakistan [2 20] and parts of the world [21 22]Herbs can grow in variety of places like roadsides homegardens farmland wild habitats and foundmore common incomparison to other growth forms The highest tree speciesutilization might be associated with their potential to surviveeven during long dry seasons thus their abundance andavailability throughout the year is higher in arid and semiaridareas The findings are in line with some studies [10 23]while being contradictory with studies conducted elsewherewhere shrubs were more frequently used [24 25] Variationin medicinal plants growth form might be associated withdifferent sociocultural beliefs ecological status and variationin practices of traditional healers of different regions orcountries Women mostly use perennial plants (78) for thetreatment of gynaecological problems The reason behindusing perennial plants might be due to the fact that highnumber of herbs and trees in the studied regions are perennialin their reproduction status

Women of studied regions use reported medicinal plantsfor the treatment of nine types of gynaecological ailmentsMenses was found to be the most treated ailment in thestudied regions Total of 19 plants were used to treat mensesrelated problems followed by 11 plants each for gonorrhea andpregnancy 10 for gynae 6 for abortifacient 5 for leucorrheaand 2 plants each for mastitis and impotency and singleplant is used for abortion Higher plant utilization for mensesmight be due to natural phenomenon associated with varietyof complications such as abdominal or pelvic cramping

BioMed Research International 7

Table 3 Fic values of traditional medicinal plants for treating gynaecological problems in study regions

Gynaecological problems Bannu Karak Kohat Chitral Mansehra MalakandMenses 088 091 100 087 mdash 097Gonorrhea 091 093 083 mdash 092 092Mastitis 100 100 100 mdash mdash 100Pregnancy 094 081 mdash 090 072 072Leucorrhoea 091 096 082 mdash 092 100Abortion 100 mdash mdash mdash mdash mdashGynae 082 052 075 072 063 061Female impotency 091 093 mdash mdash 100 100

Table 4 Ethnographic data of study regions

Ethnographic characters Bannu Karak Malakand Chitral Mansehra Kohat PercentageAge groups

40ndash50 6 5 7 4 5 4 1051ndash60 15 12 13 12 10 10 2461ndash70 20 22 21 23 20 26 4471ndash80 9 11 9 11 15 10 22

EducationIlliterate 22 19 23 17 19 20 40Primary 18 22 20 14 19 19 38Middle 5 6 2 9 6 6 11Secondary 3 2 3 6 4 4 7University 2 1 2 4 2 1 4

OccupationHousewives 43 39 46 47 41 43 86Teachers 7 11 4 3 9 7 14

lower back pain bloating and sore breasts food cravingsmood swings and irritability headache and fatigue [2627] Different plants have been found effective in relievingmenses complications like Justicia adhatoda Schinus molleConvolvulus arvensis Cyperus rotundus and Hypericum per-foratum Rural women use different parts of plant to prepareethnomedicines however use of specific plant part dependsupon plant habit and user requirements Traditional healersmostly prefer leaves and whole plant for the formulation ofgynaecological recipes The selection of specific plant partssuggests that these parts have strong healing potential againstgynaecological disorders but these parts need phytochemicalscreening and pharmacological investigation in order tocross-check traditional knowledge Present findings are inline with other studies showing leaves and whole plants asthe most frequently used plant parts for the preparation ofdifferent ethnomedicines [21 22 28] Whole plant harvestingis considered a destructive type of harvesting and causespopulation reduction of plant species

Most of the plants were found used in more than oneregion for the same particular ailment for example Con-volvulus arvensis was used against menses complication inBannu Kohat Karak and Malakand Melia azadirachta wasfound to be effective against gonorrhea in Bannu and KarakSolanum surattense was being used against gonorrhea andpregnancy in Malakand Bannu and Kohat Such types of

resemblance using similar plants for the same type of ailmentsin different cultures or regions provide a strong signal ofbioactivity potential of the documented plant species Infor-mant consensus results showed high consensus values rangesbetween 06 and 100 for 9 disease categories in different areasHigh Fic values in these regions indicate high prevalence ofgiven gynaecological problems in these regions Accordingto Heinrich et al [17] high Fic values are very useful inthe selection of specific plants for further search of bioactivecompounds Most of the diseases were found to be treatedwith only one or two plants in the studied regions and theirFic score was also high 100 Such plants should furtherbe analyzed for their phytochemical and pharmacologicalinvestigation

Ethnographic data showed that majority of the females(44) interviewed were aged between 61 and 70 years Theseresults clearly indicate that traditional knowledge is restrictedto aged people in these regions due to least interest ofyounger generation Total of 40 informants were illiteratein these regions followed by 38 who had only primary levelof education Only 4 respondents had university level ofeducation which reflects the unavailability of standard edu-cational institutions in these areas Literate people had lessknowledge about medicinal plants as compared to illiteratepeople of the regions due to modernization and changing lifestyles Total of 86 women were housewives while only 14

8 BioMed Research International

of females were school teachers that might be due to the factthat in remote areas of Pakistan women are mostly confinedto homes due to variety of customs and religious restrictionsIn rural areas girls are supposed to be future wives mothersand housekeepers little attention is given to their formaleducation Rural women have little access to educationparticularly at higher levels Even at the primary and sec-ondary levels access is restricted retention rates are low andfacilities particularly in rural areas remain abysmal Womenare poorly represented in higher and technical education andthus have poor employment prospects The women do notget sufficient medical treatment due to unavailability of themedical facilities Low literacy rate lack of medical facilitiesand low income of the people are the main factors for theirgreater dependency on medicinal plants

5 Conclusions

The present study concluded that women in remote areasof Pakistan have great dependency on medicinal plants forthe treatment of different gynaecological problems Studiedregions contain considerable number of medicinal plantsused by the traditional healers in different herbal formu-lations Menses and gonorrhea were found to be the mostprevalent complications in the studied region Plants scoringhigh Fic value should be further evaluated for their phyto-chemical and pharmacological investigation Ethnogynaeco-logical knowledge is only restricted to aged women whileyoung generation is totally ignorant Young girls should beeducated regarding the importance of traditional knowledgeMoreover detailed studies on ethnogynaecological plantsshould be carried out before the extinction of this valuableknowledge

Conflict of Interests

The authors declare that there is no conflict of interestsregarding the publication of this paper

Authorsrsquo Contribution

Muhammad Adnan and Akash Tariq have designed theresearch project Akash Tariq Sakina Mussarat and ShaheenBegum conducted field work and collected ethnomedicinaldata After collection of data these authors analyzed the dataand prepared the whole paper Muhammad Adnan AkashTariq Riaz Ullah and Naser M AbdElsalam supervised allthe stages and provided comments on the draft All authorshave read and approved the final paper

Acknowledgments

The authors are thankful to the Deanship of Scientific Re-search King Saud University Riyadh Saudi Arabia for fund-ing the work through the Research Group Project no RGP-210 The authors offer special thanks to the local respondentsfor sharing their valuable knowledge

References

[1] B Sandhya S Thomas W Isabel and R Shenbagarathai ldquoEth-nomedical plants used by the Valaiyan community of Piran-malai Hills (Reserved Forest) Tamilnadu Indiamdasha pilot studyrdquoAfrican Journal of Traditional Complementary and AlternativeMedicines vol 3 no 1 pp 101ndash114 2006

[2] Z K Shinwari ldquoMedicinal plants research in Pakistanrdquo Journalof Medicinal Plant Research vol 4 pp 161ndash176 2010

[3] D C Deka V Kumar C Prasad et al ldquoOroxylum indicummdashamedicinal plant of North East India an overview of itsnutritional remedial and prophylactic propertiesrdquo Journal ofApplied Pharmaceutical Science vol 3 no 4 pp S104ndashS1122013

[4] E Nasir and S I Ali ldquoFlora of west Pakistanrdquo Tech Rep 1-190Pakistan Agriculture Research Council Islamabad Pakistan1971ndash1991

[5] A H M Rahman ldquoEthno-gynecological study of tradi-tional medicinal plants used by santals of Joypurhat DistrictBangladeshrdquo Biomedicine and Biotechnology vol 2 pp 10ndash132014

[6] C K Kaingu J A Oduma and T I Kanui ldquoPractices of tradi-tional birth attendants in Machakos District Kenyardquo Journal ofEthnopharmacology vol 137 no 1 pp 495ndash502 2011

[7] R A Qureshi M Ghufran S A Gilani A G Yousaf and ABatool ldquoIndigenous medicinal plants used by local women insouthern Himalayan regions of Pakistanrdquo Pakistan Journal ofBotany vol 41 no 1 pp 19ndash25 2009

[8] R B Tareen T Bibi M A Khan M Ahmad and M ZafarldquoIndigenous knowledge of folk medicine by the women of Kalatand Khuzdar regions of Balochistan Pakistanrdquo Pakistan Journalof Botany vol 42 no 3 pp 1465ndash1485 2010

[9] M Adnan I Ullah A Tariq et al ldquoEthnomedicine use in thewar affected region of northwest Pakistanrdquo Journal of Ethnobi-ology and Ethnomedicine vol 10 no 1 article 16 2014

[10] W Murad A Azizullah M Adnan et al ldquoEthnobotanicalassessment of plant resources of Banda Daud Shah DistrictKarak Pakistanrdquo Journal of Ethnobiology and Ethnomedicinevol 9 no 1 article 77 2013

[11] H ul HassanWMurad A Tariq andA Ahmad ldquoEthnoveteri-nary study of medicinal plants in Malakand Valley District Dir(Lower) Khyber Pakhtunkhwa Pakistanrdquo Irish Veterinary Jour-nal vol 67 article 6 2014

[12] I Ilahi ldquoEthnobotanical studies and problems associated withregeneration of herbals in kohat regionrdquo Pakistan Journal ofBotany vol 40 no 4 pp 1743ndash1753 2008

[13] S Shinwari R Qureshi and E Baydoun ldquoEthnobotanical studyof Kohat Pass (Pakistan)rdquo Pakistan Journal Botany vol 43 pp135ndash139 2011

[14] F Hadi A Razzaq A Rahman and A Rashid ldquoEthnobotanicalnotes onwoody plants of RechValley TorkhowDistrict ChitralHindu-Kush range Pakistanrdquo Scholarly Journal of AgriculturalScience vol 3 no 11 pp 468ndash472 2013

[15] M Giday T Teklehaymanot A Animut and Y MekonnenldquoMedicinal plants of the Shinasha Agew-awi and Amharapeoples in northwest Ethiopiardquo Journal of Ethnopharmacologyvol 110 no 3 pp 516ndash525 2007

[16] R T Trotter and M H Logan ldquoInformants consensus a newapproach for identifying potentially effective medicinal plantsrdquoin Plants in Indigenous Medicine and Diet N L Etkin Ed pp91ndash112 Redgrave Bedford Hill NY USA 1986

BioMed Research International 9

[17] M Heinrich A Ankli B Frei C Weimann and O SticherldquoMedicinal plants in Mexico healersrsquo consensus and culturalimportancerdquo Social Science and Medicine vol 47 no 11 pp1859ndash1871 1998

[18] M Canales T Hernandez J Caballero et al ldquoInformantconsensus factor and antibacterial activity of the medicinalplants used by the people of San Rafael Coxcatlan PueblaMexicordquo Journal of Ethnopharmacology vol 97 no 3 pp 429ndash439 2005

[19] MKhan andFHussain ldquoConservation status of plant species inTehsil Takht-eNasrati District Karak Khyber PakhtunKhawaPakistanrdquo International Journal of Biodiversity and Conserva-tion vol 5 pp 20ndash26 2013

[20] N Khan M Ahmed A Ahmed et al ldquoImportant medicinalplants of Chitral Gol National Park (CGNP) Pakistanrdquo PakistanJournal of Botany vol 43 no 2 pp 797ndash809 2011

[21] CMuthuM Ayyanar N Raja and S Ignacimuthu ldquoMedicinalplants used by traditional healers in Kancheepuram District ofTamil Nadu Indiardquo Journal of Ethnobiology and Ethnomedicinevol 2 article 43 2006

[22] C P Kala ldquoEthnomedicinal botany of the Apatani in theEasternHimalayan region of Indiardquo Journal of Ethnobiology andEthnomedicine vol 1 article 11 2005

[23] AMaroyi ldquoTraditional use of medicinal plants in south-centralZimbabwe review and perspectivesrdquo Journal of Ethnobiologyand Ethnomedicne vol 9 article 31 2011

[24] M J Moshi D F Otieno and A Weisheit ldquoEthnomedicine ofthe Kagera Region north western Tanzania Part 3 plants usedin traditional medicine in Kikuku village Muleba DistrictrdquoJournal of Ethnobiology and Ethnomedicine vol 8 article 142012

[25] S B Padal Y Vijayakumar R J Butchi and P ChandrasekharldquoEthnomedicinal uses of Shrub species by tribals of BorraPanchayat Ananthagiri Mandalam Visakhapatnam districtAndhra Pradesh Indiardquo International Journal of PharmaceuticalScience Invention vol 2 pp 10ndash12 2013

[26] P Sharma C Malhotra D K Taneja and R Saha ldquoProblemsrelated to menstruation amongst adolescent girlsrdquo Indian Jour-nal of Pediatrics vol 75 no 2 pp 125ndash129 2008

[27] K Yamamoto A Okazaki Y Sakamoto and M Funatsu ldquoTherelationship between premenstrual symptoms menstrual painirregular menstrual cycles and psychosocial stress amongJapanese college studentsrdquo Journal of Physiological Anthropol-ogy vol 28 no 3 pp 129ndash136 2009

[28] J A Bhat M Kumar and R W Bussmann ldquoEcological statusand traditional knowledge of medicinal plants in KedarnathWildlife Sanctuary of Garhwal Himalaya Indiardquo Journal ofEthnobiology and Ethnomedicine vol 9 no 1 article 1 2013

Submit your manuscripts athttpwwwhindawicom

Stem CellsInternational

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

MEDIATORSINFLAMMATION

of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Behavioural Neurology

EndocrinologyInternational Journal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Disease Markers

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

BioMed Research International

OncologyJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Oxidative Medicine and Cellular Longevity

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

PPAR Research

The Scientific World JournalHindawi Publishing Corporation httpwwwhindawicom Volume 2014

Immunology ResearchHindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Journal of

ObesityJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Computational and Mathematical Methods in Medicine

OphthalmologyJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Diabetes ResearchJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Research and TreatmentAIDS

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Gastroenterology Research and Practice

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Parkinsonrsquos Disease

Evidence-Based Complementary and Alternative Medicine

Volume 2014Hindawi Publishing Corporationhttpwwwhindawicom

BioMed Research International 3

latitude and 71∘1110158403210158401015840 and 73∘5110158403410158401015840E longitude with a popu-lation of about 320000 [14] Mansehra is located at 34∘201015840N73∘121015840E of KPK a province Majority of the population inthe study regions are dominated by the Pashtunrsquos ethnicgroup All the regions are rural in nature and women ofthe regions are greatly dependent upon medicinal plants andforest resources for their primary health care need and forimproving their livelihood

22 Sampling and Data Collection Data of present study wasdocumented from January 2014 to June 2014 Prior to datacollection a brief group discussion was held with the rep-resentatives (Sherin Zaman Faiz Ullah Khan and NazirKhan) of communities locally known as ldquoMalikrdquo in order togain their consent to explain objectives of the researchstudy and to assure them protection of their traditionalknowledge The selection of informants was mainly based ontheir rich indigenous knowledge and long term experience ofutilization of plants Total of 300 female respondents wereselected in six regions with 50 informants in each area Lessnumber of informant selections in each area is due to thereason of cultural and religious restrictions of females Theselected respondents were local inhabitants of the regionsaged between 40 and 80 years Data was collected in the locallanguage of the respondents and then converted into EnglishSemistructured questionnaires were designed to collect eth-nomedicinal and ethnographic data The informants wereasked about the number of gynaecological plants known tothem their gynaecological applications and their parts usedEthnographic data about the age occupation and educationof the informants were also collected All the respondents andfocal persons of the study area provided permission to publishand protect the data on traditional medicines provided bythem

23 Specimen Collection and Identification Plants docu-mented by key respondents were collected from home gar-dens and natural vegetation during field surveyThe collectedvoucher specimens were taken to the Herbarium of KohatUniversity of Science and Technology (KUST) Kohat Pak-istan

Specimen identification and confirmation were under-taken by using Flora of Pakistan and taxonomic expertsSpecimens with their label were stored at the Herbarium ofKUST

24 Data Organization The collected data on ethnogy-naecological plants and ethnography of the respondentswas organized using Microsoft Excel 2007 and summarizedusing graphical statistical methods such as percentages Thehabit of the plants was categorized into 3 classes (herbsshrubs and trees) Reproduction of medicinal plants wasclassified into annual biennial and perennial Plant partswere classified into leaves roots stem whole plant seedsfruit and flower Gynaecological disorders were dividedinto 9 categories that is menses gonorrhea leucorrhoeaabortion pregnancy gynae abortifacient female impotencyand mastitis Ages of the respondents were categorized into

0

5

10

15

20

25

Bannu Karak Malakand Mansehra Chitral Kohat

Number of plantsNumber of gynaecological problems

Figure 2 Number of plants and gynaecological problems treated indifferent regions of Pakistan

four groups (40ndash50 51ndash60 61ndash70 and 71ndash80) Education ofthe female respondents was classified into 5 classes that isilliterate primary middle secondary and university level ofeducation Occupation of the females was divided into onlytwo classes (housewives and teachers)

25 Data Analysis

251 Informant Consensus Factor (Fic) Fic was used to forthe general uses of plants in different study areas and toindicate plants of particular interests Informantsrsquo consensusis the most preferred method to highlight widely used plantsfor a particular ailment and thus aids in the selection of plantsfor pharmacological and phytochemical studies [15] Prior tousing this method illnesses were classified into categoriesas high Fic plants are likely to be more pharmacologicallyactive in comparison with low Fic value plants [16] Fic valueslie between ldquo000 and 100rdquo Fic values are always greaterwhen single plant or few plants are used by large number ofinformants to cure a specific disorder while low Fic valuesgive an indication that informants do not agree over whichplant to use [17 18] The Fic can be calculated using theformula as follows

Fic = nur minus ntnur minus 1

(1)

where Fic = informants consensus factor nur = number of usecitation in each category and nt = number of species used

3 Results

The present study revealed that women of studied regionsused about 51 plants belonging to 36 families (Table 1) Bannuregion was found with high number of gynaecological plants(22) followed by Karak (15) Malakand (14) Mansehra (11)Chitral (10) and Kohat (8) Nine types of diseases weretreated in Bannu followed by eight in Karak (Figure 2)Women of the regions mostly used herbs (59) for thepreparation of ethnomedicines followed by trees (266)(Table 2) It was found that majority of the plants (78)were perennial in their mode of reproduction Women of the

4 BioMed Research International

Table1Ethn

omedicinalplantsused

totre

atgynecologicalproblem

s

Plantfam

ilies

Scientificn

amesvou

cher

no

Localn

ames

Habit

Reprod

uctio

nPartused

Region

Gyn

aecological

prob

lems

Acanthaceae

Justicia

adhatoda

LKU

H-810

Baikar

Shrub

Perenn

ial

Rootleaves

MalakandKa

rak

Bann

uGyn

aeabo

rtifa

cient

Amaranthaceae

Achyranthesa

speraLKU

H-811

Kurshaka

Herb

Perenn

ial

Who

leplant

KohatMalakand

Gon

orrhea

Anacardiaceae

Schinu

smolleLKU

H-812

Toor

maruch

Tree

Perenn

ial

Barkleaffruits

Bann

uMenses

Amaryllid

aceae

Alliu

msativ

umLKU

H-813

Thom

aHerb

Perenn

ial

Seeds

Karak

Menses

Alliu

mcepa

LKU

H-814

Thrashto

Herb

Perenn

ial

Bulb

Chitral

Gyn

aem

enses

Brassic

aceae

Brassicacampestr

isLKU

H-815

Sarson

Herb

Ann

ual

Leaves

MalakandKo

hat

Karak

Mastitis

Sisymbrium

irioLKU

H-816

Khelik

heli

Herb

Ann

ual

Seeds

ChitralK

arakB

annu

Pregnancy

Cann

abaceae

Cann

abissativaLKU

H-817

Bang

aHerb

Ann

ual

Leaves

andbark

Bann

uMalakand

Mansehra

Gon

orrheapregn

ancy

Cela

straceae

Gymnosporiaroyleana

Wallex

MAL

awsonKU

H-818

Pataki

Shrub

Perenn

ial

Seed

MansehraKa

rak

Pregnancy

Con

volvulaceae

Convolvulusa

rvensis

LKU

H-819

Pryvatay

Herb

Perenn

ial

Who

leplant

KarakBa

nnu

MalakandKo

hat

Menses

Cucurbita

ceae

Citru

lluscolocynthis(L)Schrad

KUH-820

Maraginyetr

uhHerb

Perenn

ial

Rootsa

ndfruits

Bann

uAb

ortifacientm

astitis

Cyperaceae

Cyperusrotun

dusL

KUH-821

Delloca

Herb

Perenn

ial

Who

leplant

Bann

uMenses

Equisetaceae

Equisetum

ramosissim

umDesf

KUH-822

Jorterhorse

tail

Herb

Perenn

ial

Who

leplant

Mansehra

Gon

orrhea

Fabaceae

Acaciafarnesiana

(L)Willd

KUH-823

Vilayatikikar

Tree

Perenn

ial

Gum

Kohat

Leucorrhoea

Acaciamodesta

WallKU

H-824

Palosa

Tree

Perenn

ial

Who

leplant

KohatKa

rakBa

nnu

Mansehra

Gon

orrheagyn

ae

Acacianilotica(L)Willdex

DelileKU

H-825

Kikar

Tree

Perenn

ial

Leavesbarkpo

dBa

nnuKa

rak

Mansehra

Gyn

aegon

orrhea

leucorrheafem

ale

impo

tency

Medica

gosativaLKU

H-826

Malkind

yeHerb

Perenn

ial

Leavesstem

Bann

uMenses

LotuscorniculatusL

KUH-827

Rub

Herb

Perenn

ial

Who

leplant

Chitral

Pregnancy

Hypericaceae

Hypericu

mperfo

ratum

LKU

H-828

Sheenchai

Herb

Perenn

ial

Fruitshoo

tMalakand

Menses

Juglandaceae

Jugla

nsregiaLKU

H-829

Ghu

zTree

Perenn

ial

Bark

KohatMansehra

Gyn

ae

Juncaceae

Juncus

thom

soniiB

uchenau

KUH-830

Gaw

agHerb

Perenn

ial

Who

leplant

Chitral

Pregnancy

Lamiaceae

Menthavirid

is(L)LKU

H-831

Podina

Herb

Perenn

ial

Leaves

Malakand

Menses

Thym

usserpyllum

LKU

H-832

Mervezei

Herb

Perenn

ial

Who

leplant

Bann

uMensesgynae

Malvaceae

Abelm

oschus

esculen

tus(L)

MoenchKU

H-833

Bhindi

Herb

Ann

ual

Fruits

Karak

Gon

orrhea

Abutilonindicum

(L)Sw

eet

KUH-834

Koso

beta

Shrub

Ann

ual

Who

leplant

Bann

uLeucorrhoeagynae

gono

rrheaabortio

nMalva

parvifloraLKU

H-835

Tikalai

Herb

Ann

ual

Leaves

Bann

uMenses

BioMed Research International 5

Table1Con

tinued

Plantfam

ilies

Scientificn

amesvou

cher

no

Localn

ames

Habit

Reprod

uctio

nPartused

Region

Gyn

aecological

prob

lems

Meliaceae

Meliaazadira

chta

LKU

H-836

Bakana

Tree

Perenn

ial

Barkfruits

gum

Bann

uKa

rak

Gon

orrhea

Myrtaceae

Eucalyptus

globu

lusL

abill

KUH-837

Lachi

Tree

Perenn

ial

Leavesoilste

mMalakand

Menses

Nyctaginaceae

Boerhaviacoccinea

Mill

KUH-838

Insutp

unara

Herb

Perenn

ial

Who

leplant

Malakand

Menses

Oleaceae

Olea

ferrugineaRo

yleK

UH-839

Khu

naTree

Perenn

ial

Fruits

leaves

Malakand

Menses

Fraxinus

xanthoxyloides(G

Don

)AD

CKU

H-840

Toor

Herb

Perenn

ial

Barkstemleaves

Chitral

Gyn

ae

Papaveraceae

Papaversom

nifer

umLKU

H-841

Posat

Herb

Ann

ual

Flow

erfruit

Mansehra

Abortifacientpregn

ancy

Plum

baginaceae

Plum

bago

zeylanica

LKU

H-842

Chmchip

attar

Shrub

Perenn

ial

Root

Mansehra

Abortifacient

Plantaginaceae

Veronica

agrestisL

KUH-843

Kho

sobeta

Herb

Ann

ual

Who

leplant

Bann

uMensespregnancy

Poaceae

Arun

dodona

xLKU

H-844

Herb

Perenn

ial

Stem

rhizome

Bann

uMenses

Desmostachya

bipinn

ata(L)

StapfK

UH-845

Gharc

hichon

aGrass

Perenn

ial

Who

leplant

Karak

Menses

Polygonaceae

Polyg

onum

biaristatum

Aitchamp

Hem

slKU

H-846

How

arSh

rub

Perenn

ial

Who

leplant

Bann

uGon

orrhea

Ranu

nculaceae

Aconitu

mheterophyllum

Wallex

RoyleK

UH-847

Patris

bhangdewana

sarbaw

ali

Herb

Perenn

ial

Latexroot

Mansehra

Gyn

ae

Rham

naceae

Zizip

husm

auritiana

Lam

KUH-848

Bera

Tree

Perenn

ial

Leavesbarkseeds

Bann

uGyn

ae

Rosaceae

Crataegussongaric

aK

Koch

KUH-849

Gho

nii

Tree

Perenn

ial

Leavesstembark

Chitral

Gyn

ae

Rubiaceae

Rand

iatetra

spermaBe

nthamp

Hoo

kfKU

H-850

Mainp

hal

Shrub

Perenn

ial

fruit

Chitral

Abortifacient

Rutaceae

Zanthoxylum

armatum

DC

KUH-851

Timbar

Tree

Perenn

ial

Fruitleaves

Mansehra

Abortifacient

Salicaceae

Salix

acmophylla

BoissK

UH-852

Chekar

Herb

Perenn

ial

Leavestwigs

Chitral

Menses

Saxifragaceae

Bergeniastracheyi(H

ookfamp

Thom

son)

EnglK

UH-853

Bisabu

rHerb

Perenn

ial

Leavesroo

tslatex

Chitral

Pregnancy

Solanaceae

Hyoscyamus

nigerL

KUH-854

Joligao

Herb

Biennial

Leaves

Chitral

Pregnancy

Solanu

msuratte

nseB

urmf

KUH-855

Manragh

onaym

ahok

riHerb

Biennial

Who

leplant

MalakandBa

nnu

Kohat

Gon

orrheapregn

ancy

With

aniacoagulan

s(Stocks)

Dun

alKU

H-856

Panirpanird

oda

Herb

Ann

ual

Fruits

KohatKa

rakBa

nnu

Leucorrhoea

With

aniasomnifer

a(L)Dun

alKU

H-857

Kotilaljanglip

aneer

Shrub

Perenn

ial

Who

leplant

MalakandMansehra

KarakBa

nnu

Leucorrheafem

ale

impo

tencymenses

DaturametelLKU

H-858

Barbaka

Shrub

Perenn

ial

Who

leplant

KarakBa

nnu

Gon

orrhea

Tamaricaceae

Tamarixaphylla

(L)HK

arst

KUH-859

Sheengh

azz

Tree

Perenn

ial

Leavesbark

KarakBa

nnu

Gyn

ae

Verbenaceae

Verbenaoffi

cinalisLKU

H-860

Koso

beeta

Herb

Perenn

ial

Who

leplant

Bann

uMalakand

Pregnancymenses

6 BioMed Research International

Table 2 General attributes of medicinal plants

Attribute Total number Percentage ()Part use

Leaves 16 313Whole plant 17 333Fruit 10 192Bark 6 115Root 5 96Stem 4 76Seed 4 76Flower 1 19

HabitHerb 31 59Shrub 7 134Trees 14 269

ReproductionAnnual 9 173Biennial 2 38Perennial 41 788

02468

101214161820

Num

ber o

f pla

nts

Abor

tion

Impo

tenc

y

Mas

titis

Leuc

orrh

oea

Abor

tifac

ient

Gyn

ae

Preg

nanc

y

Gon

orrh

ea

Men

ses

Gynaecological problems

Figure 3 Number of plants used to treat gynaecological problems

regions used different plant parts for the recipe preparationbut whole plant and leaves (33 and 31 resp) were foundto be the most frequent parts used against gynaecologicalcomplaints (Table 2) Nine types of gynaecological ailmentswere treated in study areas Majority of the plants (19) werefound to be used against menses followed by 11 plants eachfor gonorrhea and pregnancy related problems (Figure 3) Ficresults showed that all plants in different areas scored highconsensus ranges between 06 and 100 (Table 3) Majorityof the female respondents (44) were aged between 61 and70 years Total of 40 informants were illiterate followed by38 who had just primary level of education Majority of thefemales (86) interviewed were housewives followed by 14school teachers (Table 4)

4 Discussion

Present study results showed that women of studied remoteareas of Pakistan have strong traditional knowledge in theutilization of medicinal plants for variety of gynaecologi-cal disorders Traditionally the rural women prefer plantmedicines rather than modern medicine for their personalailments due to lack of modern facilities in the regionsAmong all studied regions Bannu was ranked first havinglarge number of gynaecological plants High number ofmedicinal plants in the region might be associated withthe prevalence of large number of gynaecological problemsin the Bannu region Nine types of ailments were foundtreated using ethnomedicines in Bannu region It is a waraffected region of Pakistan where traditional medicines useis a common practice [9] Karak and Malakand regions alsocontain considerable number of gynaecological plants due tothe greater plant diversity in the regions rural nature anddependency of women for their primary health care needs[11 19]

The women of the studied regions mostly use herbs(59) for the preparation of ethnomedicines followed bytrees (269) In most remote areas medicinal herbs arethe main ingredients of local medicines and consideredthe main lifeline and frequently first choice The highestuse of herbs gives an indication of the presence of greatabundance of herb species as noticed during field visits thatareas very close to houses were well covered with herbs andcenturies old traditional knowledge of the healers Commonuse of herbaceous plants has also been reported from otherregions of Pakistan [2 20] and parts of the world [21 22]Herbs can grow in variety of places like roadsides homegardens farmland wild habitats and foundmore common incomparison to other growth forms The highest tree speciesutilization might be associated with their potential to surviveeven during long dry seasons thus their abundance andavailability throughout the year is higher in arid and semiaridareas The findings are in line with some studies [10 23]while being contradictory with studies conducted elsewherewhere shrubs were more frequently used [24 25] Variationin medicinal plants growth form might be associated withdifferent sociocultural beliefs ecological status and variationin practices of traditional healers of different regions orcountries Women mostly use perennial plants (78) for thetreatment of gynaecological problems The reason behindusing perennial plants might be due to the fact that highnumber of herbs and trees in the studied regions are perennialin their reproduction status

Women of studied regions use reported medicinal plantsfor the treatment of nine types of gynaecological ailmentsMenses was found to be the most treated ailment in thestudied regions Total of 19 plants were used to treat mensesrelated problems followed by 11 plants each for gonorrhea andpregnancy 10 for gynae 6 for abortifacient 5 for leucorrheaand 2 plants each for mastitis and impotency and singleplant is used for abortion Higher plant utilization for mensesmight be due to natural phenomenon associated with varietyof complications such as abdominal or pelvic cramping

BioMed Research International 7

Table 3 Fic values of traditional medicinal plants for treating gynaecological problems in study regions

Gynaecological problems Bannu Karak Kohat Chitral Mansehra MalakandMenses 088 091 100 087 mdash 097Gonorrhea 091 093 083 mdash 092 092Mastitis 100 100 100 mdash mdash 100Pregnancy 094 081 mdash 090 072 072Leucorrhoea 091 096 082 mdash 092 100Abortion 100 mdash mdash mdash mdash mdashGynae 082 052 075 072 063 061Female impotency 091 093 mdash mdash 100 100

Table 4 Ethnographic data of study regions

Ethnographic characters Bannu Karak Malakand Chitral Mansehra Kohat PercentageAge groups

40ndash50 6 5 7 4 5 4 1051ndash60 15 12 13 12 10 10 2461ndash70 20 22 21 23 20 26 4471ndash80 9 11 9 11 15 10 22

EducationIlliterate 22 19 23 17 19 20 40Primary 18 22 20 14 19 19 38Middle 5 6 2 9 6 6 11Secondary 3 2 3 6 4 4 7University 2 1 2 4 2 1 4

OccupationHousewives 43 39 46 47 41 43 86Teachers 7 11 4 3 9 7 14

lower back pain bloating and sore breasts food cravingsmood swings and irritability headache and fatigue [2627] Different plants have been found effective in relievingmenses complications like Justicia adhatoda Schinus molleConvolvulus arvensis Cyperus rotundus and Hypericum per-foratum Rural women use different parts of plant to prepareethnomedicines however use of specific plant part dependsupon plant habit and user requirements Traditional healersmostly prefer leaves and whole plant for the formulation ofgynaecological recipes The selection of specific plant partssuggests that these parts have strong healing potential againstgynaecological disorders but these parts need phytochemicalscreening and pharmacological investigation in order tocross-check traditional knowledge Present findings are inline with other studies showing leaves and whole plants asthe most frequently used plant parts for the preparation ofdifferent ethnomedicines [21 22 28] Whole plant harvestingis considered a destructive type of harvesting and causespopulation reduction of plant species

Most of the plants were found used in more than oneregion for the same particular ailment for example Con-volvulus arvensis was used against menses complication inBannu Kohat Karak and Malakand Melia azadirachta wasfound to be effective against gonorrhea in Bannu and KarakSolanum surattense was being used against gonorrhea andpregnancy in Malakand Bannu and Kohat Such types of

resemblance using similar plants for the same type of ailmentsin different cultures or regions provide a strong signal ofbioactivity potential of the documented plant species Infor-mant consensus results showed high consensus values rangesbetween 06 and 100 for 9 disease categories in different areasHigh Fic values in these regions indicate high prevalence ofgiven gynaecological problems in these regions Accordingto Heinrich et al [17] high Fic values are very useful inthe selection of specific plants for further search of bioactivecompounds Most of the diseases were found to be treatedwith only one or two plants in the studied regions and theirFic score was also high 100 Such plants should furtherbe analyzed for their phytochemical and pharmacologicalinvestigation

Ethnographic data showed that majority of the females(44) interviewed were aged between 61 and 70 years Theseresults clearly indicate that traditional knowledge is restrictedto aged people in these regions due to least interest ofyounger generation Total of 40 informants were illiteratein these regions followed by 38 who had only primary levelof education Only 4 respondents had university level ofeducation which reflects the unavailability of standard edu-cational institutions in these areas Literate people had lessknowledge about medicinal plants as compared to illiteratepeople of the regions due to modernization and changing lifestyles Total of 86 women were housewives while only 14

8 BioMed Research International

of females were school teachers that might be due to the factthat in remote areas of Pakistan women are mostly confinedto homes due to variety of customs and religious restrictionsIn rural areas girls are supposed to be future wives mothersand housekeepers little attention is given to their formaleducation Rural women have little access to educationparticularly at higher levels Even at the primary and sec-ondary levels access is restricted retention rates are low andfacilities particularly in rural areas remain abysmal Womenare poorly represented in higher and technical education andthus have poor employment prospects The women do notget sufficient medical treatment due to unavailability of themedical facilities Low literacy rate lack of medical facilitiesand low income of the people are the main factors for theirgreater dependency on medicinal plants

5 Conclusions

The present study concluded that women in remote areasof Pakistan have great dependency on medicinal plants forthe treatment of different gynaecological problems Studiedregions contain considerable number of medicinal plantsused by the traditional healers in different herbal formu-lations Menses and gonorrhea were found to be the mostprevalent complications in the studied region Plants scoringhigh Fic value should be further evaluated for their phyto-chemical and pharmacological investigation Ethnogynaeco-logical knowledge is only restricted to aged women whileyoung generation is totally ignorant Young girls should beeducated regarding the importance of traditional knowledgeMoreover detailed studies on ethnogynaecological plantsshould be carried out before the extinction of this valuableknowledge

Conflict of Interests

The authors declare that there is no conflict of interestsregarding the publication of this paper

Authorsrsquo Contribution

Muhammad Adnan and Akash Tariq have designed theresearch project Akash Tariq Sakina Mussarat and ShaheenBegum conducted field work and collected ethnomedicinaldata After collection of data these authors analyzed the dataand prepared the whole paper Muhammad Adnan AkashTariq Riaz Ullah and Naser M AbdElsalam supervised allthe stages and provided comments on the draft All authorshave read and approved the final paper

Acknowledgments

The authors are thankful to the Deanship of Scientific Re-search King Saud University Riyadh Saudi Arabia for fund-ing the work through the Research Group Project no RGP-210 The authors offer special thanks to the local respondentsfor sharing their valuable knowledge

References

[1] B Sandhya S Thomas W Isabel and R Shenbagarathai ldquoEth-nomedical plants used by the Valaiyan community of Piran-malai Hills (Reserved Forest) Tamilnadu Indiamdasha pilot studyrdquoAfrican Journal of Traditional Complementary and AlternativeMedicines vol 3 no 1 pp 101ndash114 2006

[2] Z K Shinwari ldquoMedicinal plants research in Pakistanrdquo Journalof Medicinal Plant Research vol 4 pp 161ndash176 2010

[3] D C Deka V Kumar C Prasad et al ldquoOroxylum indicummdashamedicinal plant of North East India an overview of itsnutritional remedial and prophylactic propertiesrdquo Journal ofApplied Pharmaceutical Science vol 3 no 4 pp S104ndashS1122013

[4] E Nasir and S I Ali ldquoFlora of west Pakistanrdquo Tech Rep 1-190Pakistan Agriculture Research Council Islamabad Pakistan1971ndash1991

[5] A H M Rahman ldquoEthno-gynecological study of tradi-tional medicinal plants used by santals of Joypurhat DistrictBangladeshrdquo Biomedicine and Biotechnology vol 2 pp 10ndash132014

[6] C K Kaingu J A Oduma and T I Kanui ldquoPractices of tradi-tional birth attendants in Machakos District Kenyardquo Journal ofEthnopharmacology vol 137 no 1 pp 495ndash502 2011

[7] R A Qureshi M Ghufran S A Gilani A G Yousaf and ABatool ldquoIndigenous medicinal plants used by local women insouthern Himalayan regions of Pakistanrdquo Pakistan Journal ofBotany vol 41 no 1 pp 19ndash25 2009

[8] R B Tareen T Bibi M A Khan M Ahmad and M ZafarldquoIndigenous knowledge of folk medicine by the women of Kalatand Khuzdar regions of Balochistan Pakistanrdquo Pakistan Journalof Botany vol 42 no 3 pp 1465ndash1485 2010

[9] M Adnan I Ullah A Tariq et al ldquoEthnomedicine use in thewar affected region of northwest Pakistanrdquo Journal of Ethnobi-ology and Ethnomedicine vol 10 no 1 article 16 2014

[10] W Murad A Azizullah M Adnan et al ldquoEthnobotanicalassessment of plant resources of Banda Daud Shah DistrictKarak Pakistanrdquo Journal of Ethnobiology and Ethnomedicinevol 9 no 1 article 77 2013

[11] H ul HassanWMurad A Tariq andA Ahmad ldquoEthnoveteri-nary study of medicinal plants in Malakand Valley District Dir(Lower) Khyber Pakhtunkhwa Pakistanrdquo Irish Veterinary Jour-nal vol 67 article 6 2014

[12] I Ilahi ldquoEthnobotanical studies and problems associated withregeneration of herbals in kohat regionrdquo Pakistan Journal ofBotany vol 40 no 4 pp 1743ndash1753 2008

[13] S Shinwari R Qureshi and E Baydoun ldquoEthnobotanical studyof Kohat Pass (Pakistan)rdquo Pakistan Journal Botany vol 43 pp135ndash139 2011

[14] F Hadi A Razzaq A Rahman and A Rashid ldquoEthnobotanicalnotes onwoody plants of RechValley TorkhowDistrict ChitralHindu-Kush range Pakistanrdquo Scholarly Journal of AgriculturalScience vol 3 no 11 pp 468ndash472 2013

[15] M Giday T Teklehaymanot A Animut and Y MekonnenldquoMedicinal plants of the Shinasha Agew-awi and Amharapeoples in northwest Ethiopiardquo Journal of Ethnopharmacologyvol 110 no 3 pp 516ndash525 2007

[16] R T Trotter and M H Logan ldquoInformants consensus a newapproach for identifying potentially effective medicinal plantsrdquoin Plants in Indigenous Medicine and Diet N L Etkin Ed pp91ndash112 Redgrave Bedford Hill NY USA 1986

BioMed Research International 9

[17] M Heinrich A Ankli B Frei C Weimann and O SticherldquoMedicinal plants in Mexico healersrsquo consensus and culturalimportancerdquo Social Science and Medicine vol 47 no 11 pp1859ndash1871 1998

[18] M Canales T Hernandez J Caballero et al ldquoInformantconsensus factor and antibacterial activity of the medicinalplants used by the people of San Rafael Coxcatlan PueblaMexicordquo Journal of Ethnopharmacology vol 97 no 3 pp 429ndash439 2005

[19] MKhan andFHussain ldquoConservation status of plant species inTehsil Takht-eNasrati District Karak Khyber PakhtunKhawaPakistanrdquo International Journal of Biodiversity and Conserva-tion vol 5 pp 20ndash26 2013

[20] N Khan M Ahmed A Ahmed et al ldquoImportant medicinalplants of Chitral Gol National Park (CGNP) Pakistanrdquo PakistanJournal of Botany vol 43 no 2 pp 797ndash809 2011

[21] CMuthuM Ayyanar N Raja and S Ignacimuthu ldquoMedicinalplants used by traditional healers in Kancheepuram District ofTamil Nadu Indiardquo Journal of Ethnobiology and Ethnomedicinevol 2 article 43 2006

[22] C P Kala ldquoEthnomedicinal botany of the Apatani in theEasternHimalayan region of Indiardquo Journal of Ethnobiology andEthnomedicine vol 1 article 11 2005

[23] AMaroyi ldquoTraditional use of medicinal plants in south-centralZimbabwe review and perspectivesrdquo Journal of Ethnobiologyand Ethnomedicne vol 9 article 31 2011

[24] M J Moshi D F Otieno and A Weisheit ldquoEthnomedicine ofthe Kagera Region north western Tanzania Part 3 plants usedin traditional medicine in Kikuku village Muleba DistrictrdquoJournal of Ethnobiology and Ethnomedicine vol 8 article 142012

[25] S B Padal Y Vijayakumar R J Butchi and P ChandrasekharldquoEthnomedicinal uses of Shrub species by tribals of BorraPanchayat Ananthagiri Mandalam Visakhapatnam districtAndhra Pradesh Indiardquo International Journal of PharmaceuticalScience Invention vol 2 pp 10ndash12 2013

[26] P Sharma C Malhotra D K Taneja and R Saha ldquoProblemsrelated to menstruation amongst adolescent girlsrdquo Indian Jour-nal of Pediatrics vol 75 no 2 pp 125ndash129 2008

[27] K Yamamoto A Okazaki Y Sakamoto and M Funatsu ldquoTherelationship between premenstrual symptoms menstrual painirregular menstrual cycles and psychosocial stress amongJapanese college studentsrdquo Journal of Physiological Anthropol-ogy vol 28 no 3 pp 129ndash136 2009

[28] J A Bhat M Kumar and R W Bussmann ldquoEcological statusand traditional knowledge of medicinal plants in KedarnathWildlife Sanctuary of Garhwal Himalaya Indiardquo Journal ofEthnobiology and Ethnomedicine vol 9 no 1 article 1 2013

Submit your manuscripts athttpwwwhindawicom

Stem CellsInternational

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

MEDIATORSINFLAMMATION

of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Behavioural Neurology

EndocrinologyInternational Journal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Disease Markers

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

BioMed Research International

OncologyJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Oxidative Medicine and Cellular Longevity

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

PPAR Research

The Scientific World JournalHindawi Publishing Corporation httpwwwhindawicom Volume 2014

Immunology ResearchHindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Journal of

ObesityJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Computational and Mathematical Methods in Medicine

OphthalmologyJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Diabetes ResearchJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Research and TreatmentAIDS

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Gastroenterology Research and Practice

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Parkinsonrsquos Disease

Evidence-Based Complementary and Alternative Medicine

Volume 2014Hindawi Publishing Corporationhttpwwwhindawicom

4 BioMed Research International

Table1Ethn

omedicinalplantsused

totre

atgynecologicalproblem

s

Plantfam

ilies

Scientificn

amesvou

cher

no

Localn

ames

Habit

Reprod

uctio

nPartused

Region

Gyn

aecological

prob

lems

Acanthaceae

Justicia

adhatoda

LKU

H-810

Baikar

Shrub

Perenn

ial

Rootleaves

MalakandKa

rak

Bann

uGyn

aeabo

rtifa

cient

Amaranthaceae

Achyranthesa

speraLKU

H-811

Kurshaka

Herb

Perenn

ial

Who

leplant

KohatMalakand

Gon

orrhea

Anacardiaceae

Schinu

smolleLKU

H-812

Toor

maruch

Tree

Perenn

ial

Barkleaffruits

Bann

uMenses

Amaryllid

aceae

Alliu

msativ

umLKU

H-813

Thom

aHerb

Perenn

ial

Seeds

Karak

Menses

Alliu

mcepa

LKU

H-814

Thrashto

Herb

Perenn

ial

Bulb

Chitral

Gyn

aem

enses

Brassic

aceae

Brassicacampestr

isLKU

H-815

Sarson

Herb

Ann

ual

Leaves

MalakandKo

hat

Karak

Mastitis

Sisymbrium

irioLKU

H-816

Khelik

heli

Herb

Ann

ual

Seeds

ChitralK

arakB

annu

Pregnancy

Cann

abaceae

Cann

abissativaLKU

H-817

Bang

aHerb

Ann

ual

Leaves

andbark

Bann

uMalakand

Mansehra

Gon

orrheapregn

ancy

Cela

straceae

Gymnosporiaroyleana

Wallex

MAL

awsonKU

H-818

Pataki

Shrub

Perenn

ial

Seed

MansehraKa

rak

Pregnancy

Con

volvulaceae

Convolvulusa

rvensis

LKU

H-819

Pryvatay

Herb

Perenn

ial

Who

leplant

KarakBa

nnu

MalakandKo

hat

Menses

Cucurbita

ceae

Citru

lluscolocynthis(L)Schrad

KUH-820

Maraginyetr

uhHerb

Perenn

ial

Rootsa

ndfruits

Bann

uAb

ortifacientm

astitis

Cyperaceae

Cyperusrotun

dusL

KUH-821

Delloca

Herb

Perenn

ial

Who

leplant

Bann

uMenses

Equisetaceae

Equisetum

ramosissim

umDesf

KUH-822

Jorterhorse

tail

Herb

Perenn

ial

Who

leplant

Mansehra

Gon

orrhea

Fabaceae

Acaciafarnesiana

(L)Willd

KUH-823

Vilayatikikar

Tree

Perenn

ial

Gum

Kohat

Leucorrhoea

Acaciamodesta

WallKU

H-824

Palosa

Tree

Perenn

ial

Who

leplant

KohatKa

rakBa

nnu

Mansehra

Gon

orrheagyn

ae

Acacianilotica(L)Willdex

DelileKU

H-825

Kikar

Tree

Perenn

ial

Leavesbarkpo

dBa

nnuKa

rak

Mansehra

Gyn

aegon

orrhea

leucorrheafem

ale

impo

tency

Medica

gosativaLKU

H-826

Malkind

yeHerb

Perenn

ial

Leavesstem

Bann

uMenses

LotuscorniculatusL

KUH-827

Rub

Herb

Perenn

ial

Who

leplant

Chitral

Pregnancy

Hypericaceae

Hypericu

mperfo

ratum

LKU

H-828

Sheenchai

Herb

Perenn

ial

Fruitshoo

tMalakand

Menses

Juglandaceae

Jugla

nsregiaLKU

H-829

Ghu

zTree

Perenn

ial

Bark

KohatMansehra

Gyn

ae

Juncaceae

Juncus

thom

soniiB

uchenau

KUH-830

Gaw

agHerb

Perenn

ial

Who

leplant

Chitral

Pregnancy

Lamiaceae

Menthavirid

is(L)LKU

H-831

Podina

Herb

Perenn

ial

Leaves

Malakand

Menses

Thym

usserpyllum

LKU

H-832

Mervezei

Herb

Perenn

ial

Who

leplant

Bann

uMensesgynae

Malvaceae

Abelm

oschus

esculen

tus(L)

MoenchKU

H-833

Bhindi

Herb

Ann

ual

Fruits

Karak

Gon

orrhea

Abutilonindicum

(L)Sw

eet

KUH-834

Koso

beta

Shrub

Ann

ual

Who

leplant

Bann

uLeucorrhoeagynae

gono

rrheaabortio

nMalva

parvifloraLKU

H-835

Tikalai

Herb

Ann

ual

Leaves

Bann

uMenses

BioMed Research International 5

Table1Con

tinued

Plantfam

ilies

Scientificn

amesvou

cher

no

Localn

ames

Habit

Reprod

uctio

nPartused

Region

Gyn

aecological

prob

lems

Meliaceae

Meliaazadira

chta

LKU

H-836

Bakana

Tree

Perenn

ial

Barkfruits

gum

Bann

uKa

rak

Gon

orrhea

Myrtaceae

Eucalyptus

globu

lusL

abill

KUH-837

Lachi

Tree

Perenn

ial

Leavesoilste

mMalakand

Menses

Nyctaginaceae

Boerhaviacoccinea

Mill

KUH-838

Insutp

unara

Herb

Perenn

ial

Who

leplant

Malakand

Menses

Oleaceae

Olea

ferrugineaRo

yleK

UH-839

Khu

naTree

Perenn

ial

Fruits

leaves

Malakand

Menses

Fraxinus

xanthoxyloides(G

Don

)AD

CKU

H-840

Toor

Herb

Perenn

ial

Barkstemleaves

Chitral

Gyn

ae

Papaveraceae

Papaversom

nifer

umLKU

H-841

Posat

Herb

Ann

ual

Flow

erfruit

Mansehra

Abortifacientpregn

ancy

Plum

baginaceae

Plum

bago

zeylanica

LKU

H-842

Chmchip

attar

Shrub

Perenn

ial

Root

Mansehra

Abortifacient

Plantaginaceae

Veronica

agrestisL

KUH-843

Kho

sobeta

Herb

Ann

ual

Who

leplant

Bann

uMensespregnancy

Poaceae

Arun

dodona

xLKU

H-844

Herb

Perenn

ial

Stem

rhizome

Bann

uMenses

Desmostachya

bipinn

ata(L)

StapfK

UH-845

Gharc

hichon

aGrass

Perenn

ial

Who

leplant

Karak

Menses

Polygonaceae

Polyg

onum

biaristatum

Aitchamp

Hem

slKU

H-846

How

arSh

rub

Perenn

ial

Who

leplant

Bann

uGon

orrhea

Ranu

nculaceae

Aconitu

mheterophyllum

Wallex

RoyleK

UH-847

Patris

bhangdewana

sarbaw

ali

Herb

Perenn

ial

Latexroot

Mansehra

Gyn

ae

Rham

naceae

Zizip

husm

auritiana

Lam

KUH-848

Bera

Tree

Perenn

ial

Leavesbarkseeds

Bann

uGyn

ae

Rosaceae

Crataegussongaric

aK

Koch

KUH-849

Gho

nii

Tree

Perenn

ial

Leavesstembark

Chitral

Gyn

ae

Rubiaceae

Rand

iatetra

spermaBe

nthamp

Hoo

kfKU

H-850

Mainp

hal

Shrub

Perenn

ial

fruit

Chitral

Abortifacient

Rutaceae

Zanthoxylum

armatum

DC

KUH-851

Timbar

Tree

Perenn

ial

Fruitleaves

Mansehra

Abortifacient

Salicaceae

Salix

acmophylla

BoissK

UH-852

Chekar

Herb

Perenn

ial

Leavestwigs

Chitral

Menses

Saxifragaceae

Bergeniastracheyi(H

ookfamp

Thom

son)

EnglK

UH-853

Bisabu

rHerb

Perenn

ial

Leavesroo

tslatex

Chitral

Pregnancy

Solanaceae

Hyoscyamus

nigerL

KUH-854

Joligao

Herb

Biennial

Leaves

Chitral

Pregnancy

Solanu

msuratte

nseB

urmf

KUH-855

Manragh

onaym

ahok

riHerb

Biennial

Who

leplant

MalakandBa

nnu

Kohat

Gon

orrheapregn

ancy

With

aniacoagulan

s(Stocks)

Dun

alKU

H-856

Panirpanird

oda

Herb

Ann

ual

Fruits

KohatKa

rakBa

nnu

Leucorrhoea

With

aniasomnifer

a(L)Dun

alKU

H-857

Kotilaljanglip

aneer

Shrub

Perenn

ial

Who

leplant

MalakandMansehra

KarakBa

nnu

Leucorrheafem

ale

impo

tencymenses

DaturametelLKU

H-858

Barbaka

Shrub

Perenn

ial

Who

leplant

KarakBa

nnu

Gon

orrhea

Tamaricaceae

Tamarixaphylla

(L)HK

arst

KUH-859

Sheengh

azz

Tree

Perenn

ial

Leavesbark

KarakBa

nnu

Gyn

ae

Verbenaceae

Verbenaoffi

cinalisLKU

H-860

Koso

beeta

Herb

Perenn

ial

Who

leplant

Bann

uMalakand

Pregnancymenses

6 BioMed Research International

Table 2 General attributes of medicinal plants

Attribute Total number Percentage ()Part use

Leaves 16 313Whole plant 17 333Fruit 10 192Bark 6 115Root 5 96Stem 4 76Seed 4 76Flower 1 19

HabitHerb 31 59Shrub 7 134Trees 14 269

ReproductionAnnual 9 173Biennial 2 38Perennial 41 788

02468

101214161820

Num

ber o

f pla

nts

Abor

tion

Impo

tenc

y

Mas

titis

Leuc

orrh

oea

Abor

tifac

ient

Gyn

ae

Preg

nanc

y

Gon

orrh

ea

Men

ses

Gynaecological problems

Figure 3 Number of plants used to treat gynaecological problems

regions used different plant parts for the recipe preparationbut whole plant and leaves (33 and 31 resp) were foundto be the most frequent parts used against gynaecologicalcomplaints (Table 2) Nine types of gynaecological ailmentswere treated in study areas Majority of the plants (19) werefound to be used against menses followed by 11 plants eachfor gonorrhea and pregnancy related problems (Figure 3) Ficresults showed that all plants in different areas scored highconsensus ranges between 06 and 100 (Table 3) Majorityof the female respondents (44) were aged between 61 and70 years Total of 40 informants were illiterate followed by38 who had just primary level of education Majority of thefemales (86) interviewed were housewives followed by 14school teachers (Table 4)

4 Discussion

Present study results showed that women of studied remoteareas of Pakistan have strong traditional knowledge in theutilization of medicinal plants for variety of gynaecologi-cal disorders Traditionally the rural women prefer plantmedicines rather than modern medicine for their personalailments due to lack of modern facilities in the regionsAmong all studied regions Bannu was ranked first havinglarge number of gynaecological plants High number ofmedicinal plants in the region might be associated withthe prevalence of large number of gynaecological problemsin the Bannu region Nine types of ailments were foundtreated using ethnomedicines in Bannu region It is a waraffected region of Pakistan where traditional medicines useis a common practice [9] Karak and Malakand regions alsocontain considerable number of gynaecological plants due tothe greater plant diversity in the regions rural nature anddependency of women for their primary health care needs[11 19]

The women of the studied regions mostly use herbs(59) for the preparation of ethnomedicines followed bytrees (269) In most remote areas medicinal herbs arethe main ingredients of local medicines and consideredthe main lifeline and frequently first choice The highestuse of herbs gives an indication of the presence of greatabundance of herb species as noticed during field visits thatareas very close to houses were well covered with herbs andcenturies old traditional knowledge of the healers Commonuse of herbaceous plants has also been reported from otherregions of Pakistan [2 20] and parts of the world [21 22]Herbs can grow in variety of places like roadsides homegardens farmland wild habitats and foundmore common incomparison to other growth forms The highest tree speciesutilization might be associated with their potential to surviveeven during long dry seasons thus their abundance andavailability throughout the year is higher in arid and semiaridareas The findings are in line with some studies [10 23]while being contradictory with studies conducted elsewherewhere shrubs were more frequently used [24 25] Variationin medicinal plants growth form might be associated withdifferent sociocultural beliefs ecological status and variationin practices of traditional healers of different regions orcountries Women mostly use perennial plants (78) for thetreatment of gynaecological problems The reason behindusing perennial plants might be due to the fact that highnumber of herbs and trees in the studied regions are perennialin their reproduction status

Women of studied regions use reported medicinal plantsfor the treatment of nine types of gynaecological ailmentsMenses was found to be the most treated ailment in thestudied regions Total of 19 plants were used to treat mensesrelated problems followed by 11 plants each for gonorrhea andpregnancy 10 for gynae 6 for abortifacient 5 for leucorrheaand 2 plants each for mastitis and impotency and singleplant is used for abortion Higher plant utilization for mensesmight be due to natural phenomenon associated with varietyof complications such as abdominal or pelvic cramping

BioMed Research International 7

Table 3 Fic values of traditional medicinal plants for treating gynaecological problems in study regions

Gynaecological problems Bannu Karak Kohat Chitral Mansehra MalakandMenses 088 091 100 087 mdash 097Gonorrhea 091 093 083 mdash 092 092Mastitis 100 100 100 mdash mdash 100Pregnancy 094 081 mdash 090 072 072Leucorrhoea 091 096 082 mdash 092 100Abortion 100 mdash mdash mdash mdash mdashGynae 082 052 075 072 063 061Female impotency 091 093 mdash mdash 100 100

Table 4 Ethnographic data of study regions

Ethnographic characters Bannu Karak Malakand Chitral Mansehra Kohat PercentageAge groups

40ndash50 6 5 7 4 5 4 1051ndash60 15 12 13 12 10 10 2461ndash70 20 22 21 23 20 26 4471ndash80 9 11 9 11 15 10 22

EducationIlliterate 22 19 23 17 19 20 40Primary 18 22 20 14 19 19 38Middle 5 6 2 9 6 6 11Secondary 3 2 3 6 4 4 7University 2 1 2 4 2 1 4

OccupationHousewives 43 39 46 47 41 43 86Teachers 7 11 4 3 9 7 14

lower back pain bloating and sore breasts food cravingsmood swings and irritability headache and fatigue [2627] Different plants have been found effective in relievingmenses complications like Justicia adhatoda Schinus molleConvolvulus arvensis Cyperus rotundus and Hypericum per-foratum Rural women use different parts of plant to prepareethnomedicines however use of specific plant part dependsupon plant habit and user requirements Traditional healersmostly prefer leaves and whole plant for the formulation ofgynaecological recipes The selection of specific plant partssuggests that these parts have strong healing potential againstgynaecological disorders but these parts need phytochemicalscreening and pharmacological investigation in order tocross-check traditional knowledge Present findings are inline with other studies showing leaves and whole plants asthe most frequently used plant parts for the preparation ofdifferent ethnomedicines [21 22 28] Whole plant harvestingis considered a destructive type of harvesting and causespopulation reduction of plant species

Most of the plants were found used in more than oneregion for the same particular ailment for example Con-volvulus arvensis was used against menses complication inBannu Kohat Karak and Malakand Melia azadirachta wasfound to be effective against gonorrhea in Bannu and KarakSolanum surattense was being used against gonorrhea andpregnancy in Malakand Bannu and Kohat Such types of

resemblance using similar plants for the same type of ailmentsin different cultures or regions provide a strong signal ofbioactivity potential of the documented plant species Infor-mant consensus results showed high consensus values rangesbetween 06 and 100 for 9 disease categories in different areasHigh Fic values in these regions indicate high prevalence ofgiven gynaecological problems in these regions Accordingto Heinrich et al [17] high Fic values are very useful inthe selection of specific plants for further search of bioactivecompounds Most of the diseases were found to be treatedwith only one or two plants in the studied regions and theirFic score was also high 100 Such plants should furtherbe analyzed for their phytochemical and pharmacologicalinvestigation

Ethnographic data showed that majority of the females(44) interviewed were aged between 61 and 70 years Theseresults clearly indicate that traditional knowledge is restrictedto aged people in these regions due to least interest ofyounger generation Total of 40 informants were illiteratein these regions followed by 38 who had only primary levelof education Only 4 respondents had university level ofeducation which reflects the unavailability of standard edu-cational institutions in these areas Literate people had lessknowledge about medicinal plants as compared to illiteratepeople of the regions due to modernization and changing lifestyles Total of 86 women were housewives while only 14

8 BioMed Research International

of females were school teachers that might be due to the factthat in remote areas of Pakistan women are mostly confinedto homes due to variety of customs and religious restrictionsIn rural areas girls are supposed to be future wives mothersand housekeepers little attention is given to their formaleducation Rural women have little access to educationparticularly at higher levels Even at the primary and sec-ondary levels access is restricted retention rates are low andfacilities particularly in rural areas remain abysmal Womenare poorly represented in higher and technical education andthus have poor employment prospects The women do notget sufficient medical treatment due to unavailability of themedical facilities Low literacy rate lack of medical facilitiesand low income of the people are the main factors for theirgreater dependency on medicinal plants

5 Conclusions

The present study concluded that women in remote areasof Pakistan have great dependency on medicinal plants forthe treatment of different gynaecological problems Studiedregions contain considerable number of medicinal plantsused by the traditional healers in different herbal formu-lations Menses and gonorrhea were found to be the mostprevalent complications in the studied region Plants scoringhigh Fic value should be further evaluated for their phyto-chemical and pharmacological investigation Ethnogynaeco-logical knowledge is only restricted to aged women whileyoung generation is totally ignorant Young girls should beeducated regarding the importance of traditional knowledgeMoreover detailed studies on ethnogynaecological plantsshould be carried out before the extinction of this valuableknowledge

Conflict of Interests

The authors declare that there is no conflict of interestsregarding the publication of this paper

Authorsrsquo Contribution

Muhammad Adnan and Akash Tariq have designed theresearch project Akash Tariq Sakina Mussarat and ShaheenBegum conducted field work and collected ethnomedicinaldata After collection of data these authors analyzed the dataand prepared the whole paper Muhammad Adnan AkashTariq Riaz Ullah and Naser M AbdElsalam supervised allthe stages and provided comments on the draft All authorshave read and approved the final paper

Acknowledgments

The authors are thankful to the Deanship of Scientific Re-search King Saud University Riyadh Saudi Arabia for fund-ing the work through the Research Group Project no RGP-210 The authors offer special thanks to the local respondentsfor sharing their valuable knowledge

References

[1] B Sandhya S Thomas W Isabel and R Shenbagarathai ldquoEth-nomedical plants used by the Valaiyan community of Piran-malai Hills (Reserved Forest) Tamilnadu Indiamdasha pilot studyrdquoAfrican Journal of Traditional Complementary and AlternativeMedicines vol 3 no 1 pp 101ndash114 2006

[2] Z K Shinwari ldquoMedicinal plants research in Pakistanrdquo Journalof Medicinal Plant Research vol 4 pp 161ndash176 2010

[3] D C Deka V Kumar C Prasad et al ldquoOroxylum indicummdashamedicinal plant of North East India an overview of itsnutritional remedial and prophylactic propertiesrdquo Journal ofApplied Pharmaceutical Science vol 3 no 4 pp S104ndashS1122013

[4] E Nasir and S I Ali ldquoFlora of west Pakistanrdquo Tech Rep 1-190Pakistan Agriculture Research Council Islamabad Pakistan1971ndash1991

[5] A H M Rahman ldquoEthno-gynecological study of tradi-tional medicinal plants used by santals of Joypurhat DistrictBangladeshrdquo Biomedicine and Biotechnology vol 2 pp 10ndash132014

[6] C K Kaingu J A Oduma and T I Kanui ldquoPractices of tradi-tional birth attendants in Machakos District Kenyardquo Journal ofEthnopharmacology vol 137 no 1 pp 495ndash502 2011

[7] R A Qureshi M Ghufran S A Gilani A G Yousaf and ABatool ldquoIndigenous medicinal plants used by local women insouthern Himalayan regions of Pakistanrdquo Pakistan Journal ofBotany vol 41 no 1 pp 19ndash25 2009

[8] R B Tareen T Bibi M A Khan M Ahmad and M ZafarldquoIndigenous knowledge of folk medicine by the women of Kalatand Khuzdar regions of Balochistan Pakistanrdquo Pakistan Journalof Botany vol 42 no 3 pp 1465ndash1485 2010

[9] M Adnan I Ullah A Tariq et al ldquoEthnomedicine use in thewar affected region of northwest Pakistanrdquo Journal of Ethnobi-ology and Ethnomedicine vol 10 no 1 article 16 2014

[10] W Murad A Azizullah M Adnan et al ldquoEthnobotanicalassessment of plant resources of Banda Daud Shah DistrictKarak Pakistanrdquo Journal of Ethnobiology and Ethnomedicinevol 9 no 1 article 77 2013

[11] H ul HassanWMurad A Tariq andA Ahmad ldquoEthnoveteri-nary study of medicinal plants in Malakand Valley District Dir(Lower) Khyber Pakhtunkhwa Pakistanrdquo Irish Veterinary Jour-nal vol 67 article 6 2014

[12] I Ilahi ldquoEthnobotanical studies and problems associated withregeneration of herbals in kohat regionrdquo Pakistan Journal ofBotany vol 40 no 4 pp 1743ndash1753 2008

[13] S Shinwari R Qureshi and E Baydoun ldquoEthnobotanical studyof Kohat Pass (Pakistan)rdquo Pakistan Journal Botany vol 43 pp135ndash139 2011

[14] F Hadi A Razzaq A Rahman and A Rashid ldquoEthnobotanicalnotes onwoody plants of RechValley TorkhowDistrict ChitralHindu-Kush range Pakistanrdquo Scholarly Journal of AgriculturalScience vol 3 no 11 pp 468ndash472 2013

[15] M Giday T Teklehaymanot A Animut and Y MekonnenldquoMedicinal plants of the Shinasha Agew-awi and Amharapeoples in northwest Ethiopiardquo Journal of Ethnopharmacologyvol 110 no 3 pp 516ndash525 2007

[16] R T Trotter and M H Logan ldquoInformants consensus a newapproach for identifying potentially effective medicinal plantsrdquoin Plants in Indigenous Medicine and Diet N L Etkin Ed pp91ndash112 Redgrave Bedford Hill NY USA 1986

BioMed Research International 9

[17] M Heinrich A Ankli B Frei C Weimann and O SticherldquoMedicinal plants in Mexico healersrsquo consensus and culturalimportancerdquo Social Science and Medicine vol 47 no 11 pp1859ndash1871 1998

[18] M Canales T Hernandez J Caballero et al ldquoInformantconsensus factor and antibacterial activity of the medicinalplants used by the people of San Rafael Coxcatlan PueblaMexicordquo Journal of Ethnopharmacology vol 97 no 3 pp 429ndash439 2005

[19] MKhan andFHussain ldquoConservation status of plant species inTehsil Takht-eNasrati District Karak Khyber PakhtunKhawaPakistanrdquo International Journal of Biodiversity and Conserva-tion vol 5 pp 20ndash26 2013

[20] N Khan M Ahmed A Ahmed et al ldquoImportant medicinalplants of Chitral Gol National Park (CGNP) Pakistanrdquo PakistanJournal of Botany vol 43 no 2 pp 797ndash809 2011

[21] CMuthuM Ayyanar N Raja and S Ignacimuthu ldquoMedicinalplants used by traditional healers in Kancheepuram District ofTamil Nadu Indiardquo Journal of Ethnobiology and Ethnomedicinevol 2 article 43 2006

[22] C P Kala ldquoEthnomedicinal botany of the Apatani in theEasternHimalayan region of Indiardquo Journal of Ethnobiology andEthnomedicine vol 1 article 11 2005

[23] AMaroyi ldquoTraditional use of medicinal plants in south-centralZimbabwe review and perspectivesrdquo Journal of Ethnobiologyand Ethnomedicne vol 9 article 31 2011

[24] M J Moshi D F Otieno and A Weisheit ldquoEthnomedicine ofthe Kagera Region north western Tanzania Part 3 plants usedin traditional medicine in Kikuku village Muleba DistrictrdquoJournal of Ethnobiology and Ethnomedicine vol 8 article 142012

[25] S B Padal Y Vijayakumar R J Butchi and P ChandrasekharldquoEthnomedicinal uses of Shrub species by tribals of BorraPanchayat Ananthagiri Mandalam Visakhapatnam districtAndhra Pradesh Indiardquo International Journal of PharmaceuticalScience Invention vol 2 pp 10ndash12 2013

[26] P Sharma C Malhotra D K Taneja and R Saha ldquoProblemsrelated to menstruation amongst adolescent girlsrdquo Indian Jour-nal of Pediatrics vol 75 no 2 pp 125ndash129 2008

[27] K Yamamoto A Okazaki Y Sakamoto and M Funatsu ldquoTherelationship between premenstrual symptoms menstrual painirregular menstrual cycles and psychosocial stress amongJapanese college studentsrdquo Journal of Physiological Anthropol-ogy vol 28 no 3 pp 129ndash136 2009

[28] J A Bhat M Kumar and R W Bussmann ldquoEcological statusand traditional knowledge of medicinal plants in KedarnathWildlife Sanctuary of Garhwal Himalaya Indiardquo Journal ofEthnobiology and Ethnomedicine vol 9 no 1 article 1 2013

Submit your manuscripts athttpwwwhindawicom

Stem CellsInternational

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

MEDIATORSINFLAMMATION

of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Behavioural Neurology

EndocrinologyInternational Journal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Disease Markers

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

BioMed Research International

OncologyJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Oxidative Medicine and Cellular Longevity

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

PPAR Research

The Scientific World JournalHindawi Publishing Corporation httpwwwhindawicom Volume 2014

Immunology ResearchHindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Journal of

ObesityJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Computational and Mathematical Methods in Medicine

OphthalmologyJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Diabetes ResearchJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Research and TreatmentAIDS

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Gastroenterology Research and Practice

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Parkinsonrsquos Disease

Evidence-Based Complementary and Alternative Medicine

Volume 2014Hindawi Publishing Corporationhttpwwwhindawicom

BioMed Research International 5

Table1Con

tinued

Plantfam

ilies

Scientificn

amesvou

cher

no

Localn

ames

Habit

Reprod

uctio

nPartused

Region

Gyn

aecological

prob

lems

Meliaceae

Meliaazadira

chta

LKU

H-836

Bakana

Tree

Perenn

ial

Barkfruits

gum

Bann

uKa

rak

Gon

orrhea

Myrtaceae

Eucalyptus

globu

lusL

abill

KUH-837

Lachi

Tree

Perenn

ial

Leavesoilste

mMalakand

Menses

Nyctaginaceae

Boerhaviacoccinea

Mill

KUH-838

Insutp

unara

Herb

Perenn

ial

Who

leplant

Malakand

Menses

Oleaceae

Olea

ferrugineaRo

yleK

UH-839

Khu

naTree

Perenn

ial

Fruits

leaves

Malakand

Menses

Fraxinus

xanthoxyloides(G

Don

)AD

CKU

H-840

Toor

Herb

Perenn

ial

Barkstemleaves

Chitral

Gyn

ae

Papaveraceae

Papaversom

nifer

umLKU

H-841

Posat

Herb

Ann

ual

Flow

erfruit

Mansehra

Abortifacientpregn

ancy

Plum

baginaceae

Plum

bago

zeylanica

LKU

H-842

Chmchip

attar

Shrub

Perenn

ial

Root

Mansehra

Abortifacient

Plantaginaceae

Veronica

agrestisL

KUH-843

Kho

sobeta

Herb

Ann

ual

Who

leplant

Bann

uMensespregnancy

Poaceae

Arun

dodona

xLKU

H-844

Herb

Perenn

ial

Stem

rhizome

Bann

uMenses

Desmostachya

bipinn

ata(L)

StapfK

UH-845

Gharc

hichon

aGrass

Perenn

ial

Who

leplant

Karak

Menses

Polygonaceae

Polyg

onum

biaristatum

Aitchamp

Hem

slKU

H-846

How

arSh

rub

Perenn

ial

Who

leplant

Bann

uGon

orrhea

Ranu

nculaceae

Aconitu

mheterophyllum

Wallex

RoyleK

UH-847

Patris

bhangdewana

sarbaw

ali

Herb

Perenn

ial

Latexroot

Mansehra

Gyn

ae

Rham

naceae

Zizip

husm

auritiana

Lam

KUH-848

Bera

Tree

Perenn

ial

Leavesbarkseeds

Bann

uGyn

ae

Rosaceae

Crataegussongaric

aK

Koch

KUH-849

Gho

nii

Tree

Perenn

ial

Leavesstembark

Chitral

Gyn

ae

Rubiaceae

Rand

iatetra

spermaBe

nthamp

Hoo

kfKU

H-850

Mainp

hal

Shrub

Perenn

ial

fruit

Chitral

Abortifacient

Rutaceae

Zanthoxylum

armatum

DC

KUH-851

Timbar

Tree

Perenn

ial

Fruitleaves

Mansehra

Abortifacient

Salicaceae

Salix

acmophylla

BoissK

UH-852

Chekar

Herb

Perenn

ial

Leavestwigs

Chitral

Menses

Saxifragaceae

Bergeniastracheyi(H

ookfamp

Thom

son)

EnglK

UH-853

Bisabu

rHerb

Perenn

ial

Leavesroo

tslatex

Chitral

Pregnancy

Solanaceae

Hyoscyamus

nigerL

KUH-854

Joligao

Herb

Biennial

Leaves

Chitral

Pregnancy

Solanu

msuratte

nseB

urmf

KUH-855

Manragh

onaym

ahok

riHerb

Biennial

Who

leplant

MalakandBa

nnu

Kohat

Gon

orrheapregn

ancy

With

aniacoagulan

s(Stocks)

Dun

alKU

H-856

Panirpanird

oda

Herb

Ann

ual

Fruits

KohatKa

rakBa

nnu

Leucorrhoea

With

aniasomnifer

a(L)Dun

alKU

H-857

Kotilaljanglip

aneer

Shrub

Perenn

ial

Who

leplant

MalakandMansehra

KarakBa

nnu

Leucorrheafem

ale

impo

tencymenses

DaturametelLKU

H-858

Barbaka

Shrub

Perenn

ial

Who

leplant

KarakBa

nnu

Gon

orrhea

Tamaricaceae

Tamarixaphylla

(L)HK

arst

KUH-859

Sheengh

azz

Tree

Perenn

ial

Leavesbark

KarakBa

nnu

Gyn

ae

Verbenaceae

Verbenaoffi

cinalisLKU

H-860

Koso

beeta

Herb

Perenn

ial

Who

leplant

Bann

uMalakand

Pregnancymenses

6 BioMed Research International

Table 2 General attributes of medicinal plants

Attribute Total number Percentage ()Part use

Leaves 16 313Whole plant 17 333Fruit 10 192Bark 6 115Root 5 96Stem 4 76Seed 4 76Flower 1 19

HabitHerb 31 59Shrub 7 134Trees 14 269

ReproductionAnnual 9 173Biennial 2 38Perennial 41 788

02468

101214161820

Num

ber o

f pla

nts

Abor

tion

Impo

tenc

y

Mas

titis

Leuc

orrh

oea

Abor

tifac

ient

Gyn

ae

Preg

nanc

y

Gon

orrh

ea

Men

ses

Gynaecological problems

Figure 3 Number of plants used to treat gynaecological problems

regions used different plant parts for the recipe preparationbut whole plant and leaves (33 and 31 resp) were foundto be the most frequent parts used against gynaecologicalcomplaints (Table 2) Nine types of gynaecological ailmentswere treated in study areas Majority of the plants (19) werefound to be used against menses followed by 11 plants eachfor gonorrhea and pregnancy related problems (Figure 3) Ficresults showed that all plants in different areas scored highconsensus ranges between 06 and 100 (Table 3) Majorityof the female respondents (44) were aged between 61 and70 years Total of 40 informants were illiterate followed by38 who had just primary level of education Majority of thefemales (86) interviewed were housewives followed by 14school teachers (Table 4)

4 Discussion

Present study results showed that women of studied remoteareas of Pakistan have strong traditional knowledge in theutilization of medicinal plants for variety of gynaecologi-cal disorders Traditionally the rural women prefer plantmedicines rather than modern medicine for their personalailments due to lack of modern facilities in the regionsAmong all studied regions Bannu was ranked first havinglarge number of gynaecological plants High number ofmedicinal plants in the region might be associated withthe prevalence of large number of gynaecological problemsin the Bannu region Nine types of ailments were foundtreated using ethnomedicines in Bannu region It is a waraffected region of Pakistan where traditional medicines useis a common practice [9] Karak and Malakand regions alsocontain considerable number of gynaecological plants due tothe greater plant diversity in the regions rural nature anddependency of women for their primary health care needs[11 19]

The women of the studied regions mostly use herbs(59) for the preparation of ethnomedicines followed bytrees (269) In most remote areas medicinal herbs arethe main ingredients of local medicines and consideredthe main lifeline and frequently first choice The highestuse of herbs gives an indication of the presence of greatabundance of herb species as noticed during field visits thatareas very close to houses were well covered with herbs andcenturies old traditional knowledge of the healers Commonuse of herbaceous plants has also been reported from otherregions of Pakistan [2 20] and parts of the world [21 22]Herbs can grow in variety of places like roadsides homegardens farmland wild habitats and foundmore common incomparison to other growth forms The highest tree speciesutilization might be associated with their potential to surviveeven during long dry seasons thus their abundance andavailability throughout the year is higher in arid and semiaridareas The findings are in line with some studies [10 23]while being contradictory with studies conducted elsewherewhere shrubs were more frequently used [24 25] Variationin medicinal plants growth form might be associated withdifferent sociocultural beliefs ecological status and variationin practices of traditional healers of different regions orcountries Women mostly use perennial plants (78) for thetreatment of gynaecological problems The reason behindusing perennial plants might be due to the fact that highnumber of herbs and trees in the studied regions are perennialin their reproduction status

Women of studied regions use reported medicinal plantsfor the treatment of nine types of gynaecological ailmentsMenses was found to be the most treated ailment in thestudied regions Total of 19 plants were used to treat mensesrelated problems followed by 11 plants each for gonorrhea andpregnancy 10 for gynae 6 for abortifacient 5 for leucorrheaand 2 plants each for mastitis and impotency and singleplant is used for abortion Higher plant utilization for mensesmight be due to natural phenomenon associated with varietyof complications such as abdominal or pelvic cramping

BioMed Research International 7

Table 3 Fic values of traditional medicinal plants for treating gynaecological problems in study regions

Gynaecological problems Bannu Karak Kohat Chitral Mansehra MalakandMenses 088 091 100 087 mdash 097Gonorrhea 091 093 083 mdash 092 092Mastitis 100 100 100 mdash mdash 100Pregnancy 094 081 mdash 090 072 072Leucorrhoea 091 096 082 mdash 092 100Abortion 100 mdash mdash mdash mdash mdashGynae 082 052 075 072 063 061Female impotency 091 093 mdash mdash 100 100

Table 4 Ethnographic data of study regions

Ethnographic characters Bannu Karak Malakand Chitral Mansehra Kohat PercentageAge groups

40ndash50 6 5 7 4 5 4 1051ndash60 15 12 13 12 10 10 2461ndash70 20 22 21 23 20 26 4471ndash80 9 11 9 11 15 10 22

EducationIlliterate 22 19 23 17 19 20 40Primary 18 22 20 14 19 19 38Middle 5 6 2 9 6 6 11Secondary 3 2 3 6 4 4 7University 2 1 2 4 2 1 4

OccupationHousewives 43 39 46 47 41 43 86Teachers 7 11 4 3 9 7 14

lower back pain bloating and sore breasts food cravingsmood swings and irritability headache and fatigue [2627] Different plants have been found effective in relievingmenses complications like Justicia adhatoda Schinus molleConvolvulus arvensis Cyperus rotundus and Hypericum per-foratum Rural women use different parts of plant to prepareethnomedicines however use of specific plant part dependsupon plant habit and user requirements Traditional healersmostly prefer leaves and whole plant for the formulation ofgynaecological recipes The selection of specific plant partssuggests that these parts have strong healing potential againstgynaecological disorders but these parts need phytochemicalscreening and pharmacological investigation in order tocross-check traditional knowledge Present findings are inline with other studies showing leaves and whole plants asthe most frequently used plant parts for the preparation ofdifferent ethnomedicines [21 22 28] Whole plant harvestingis considered a destructive type of harvesting and causespopulation reduction of plant species

Most of the plants were found used in more than oneregion for the same particular ailment for example Con-volvulus arvensis was used against menses complication inBannu Kohat Karak and Malakand Melia azadirachta wasfound to be effective against gonorrhea in Bannu and KarakSolanum surattense was being used against gonorrhea andpregnancy in Malakand Bannu and Kohat Such types of

resemblance using similar plants for the same type of ailmentsin different cultures or regions provide a strong signal ofbioactivity potential of the documented plant species Infor-mant consensus results showed high consensus values rangesbetween 06 and 100 for 9 disease categories in different areasHigh Fic values in these regions indicate high prevalence ofgiven gynaecological problems in these regions Accordingto Heinrich et al [17] high Fic values are very useful inthe selection of specific plants for further search of bioactivecompounds Most of the diseases were found to be treatedwith only one or two plants in the studied regions and theirFic score was also high 100 Such plants should furtherbe analyzed for their phytochemical and pharmacologicalinvestigation

Ethnographic data showed that majority of the females(44) interviewed were aged between 61 and 70 years Theseresults clearly indicate that traditional knowledge is restrictedto aged people in these regions due to least interest ofyounger generation Total of 40 informants were illiteratein these regions followed by 38 who had only primary levelof education Only 4 respondents had university level ofeducation which reflects the unavailability of standard edu-cational institutions in these areas Literate people had lessknowledge about medicinal plants as compared to illiteratepeople of the regions due to modernization and changing lifestyles Total of 86 women were housewives while only 14

8 BioMed Research International

of females were school teachers that might be due to the factthat in remote areas of Pakistan women are mostly confinedto homes due to variety of customs and religious restrictionsIn rural areas girls are supposed to be future wives mothersand housekeepers little attention is given to their formaleducation Rural women have little access to educationparticularly at higher levels Even at the primary and sec-ondary levels access is restricted retention rates are low andfacilities particularly in rural areas remain abysmal Womenare poorly represented in higher and technical education andthus have poor employment prospects The women do notget sufficient medical treatment due to unavailability of themedical facilities Low literacy rate lack of medical facilitiesand low income of the people are the main factors for theirgreater dependency on medicinal plants

5 Conclusions

The present study concluded that women in remote areasof Pakistan have great dependency on medicinal plants forthe treatment of different gynaecological problems Studiedregions contain considerable number of medicinal plantsused by the traditional healers in different herbal formu-lations Menses and gonorrhea were found to be the mostprevalent complications in the studied region Plants scoringhigh Fic value should be further evaluated for their phyto-chemical and pharmacological investigation Ethnogynaeco-logical knowledge is only restricted to aged women whileyoung generation is totally ignorant Young girls should beeducated regarding the importance of traditional knowledgeMoreover detailed studies on ethnogynaecological plantsshould be carried out before the extinction of this valuableknowledge

Conflict of Interests

The authors declare that there is no conflict of interestsregarding the publication of this paper

Authorsrsquo Contribution

Muhammad Adnan and Akash Tariq have designed theresearch project Akash Tariq Sakina Mussarat and ShaheenBegum conducted field work and collected ethnomedicinaldata After collection of data these authors analyzed the dataand prepared the whole paper Muhammad Adnan AkashTariq Riaz Ullah and Naser M AbdElsalam supervised allthe stages and provided comments on the draft All authorshave read and approved the final paper

Acknowledgments

The authors are thankful to the Deanship of Scientific Re-search King Saud University Riyadh Saudi Arabia for fund-ing the work through the Research Group Project no RGP-210 The authors offer special thanks to the local respondentsfor sharing their valuable knowledge

References

[1] B Sandhya S Thomas W Isabel and R Shenbagarathai ldquoEth-nomedical plants used by the Valaiyan community of Piran-malai Hills (Reserved Forest) Tamilnadu Indiamdasha pilot studyrdquoAfrican Journal of Traditional Complementary and AlternativeMedicines vol 3 no 1 pp 101ndash114 2006

[2] Z K Shinwari ldquoMedicinal plants research in Pakistanrdquo Journalof Medicinal Plant Research vol 4 pp 161ndash176 2010

[3] D C Deka V Kumar C Prasad et al ldquoOroxylum indicummdashamedicinal plant of North East India an overview of itsnutritional remedial and prophylactic propertiesrdquo Journal ofApplied Pharmaceutical Science vol 3 no 4 pp S104ndashS1122013

[4] E Nasir and S I Ali ldquoFlora of west Pakistanrdquo Tech Rep 1-190Pakistan Agriculture Research Council Islamabad Pakistan1971ndash1991

[5] A H M Rahman ldquoEthno-gynecological study of tradi-tional medicinal plants used by santals of Joypurhat DistrictBangladeshrdquo Biomedicine and Biotechnology vol 2 pp 10ndash132014

[6] C K Kaingu J A Oduma and T I Kanui ldquoPractices of tradi-tional birth attendants in Machakos District Kenyardquo Journal ofEthnopharmacology vol 137 no 1 pp 495ndash502 2011

[7] R A Qureshi M Ghufran S A Gilani A G Yousaf and ABatool ldquoIndigenous medicinal plants used by local women insouthern Himalayan regions of Pakistanrdquo Pakistan Journal ofBotany vol 41 no 1 pp 19ndash25 2009

[8] R B Tareen T Bibi M A Khan M Ahmad and M ZafarldquoIndigenous knowledge of folk medicine by the women of Kalatand Khuzdar regions of Balochistan Pakistanrdquo Pakistan Journalof Botany vol 42 no 3 pp 1465ndash1485 2010

[9] M Adnan I Ullah A Tariq et al ldquoEthnomedicine use in thewar affected region of northwest Pakistanrdquo Journal of Ethnobi-ology and Ethnomedicine vol 10 no 1 article 16 2014

[10] W Murad A Azizullah M Adnan et al ldquoEthnobotanicalassessment of plant resources of Banda Daud Shah DistrictKarak Pakistanrdquo Journal of Ethnobiology and Ethnomedicinevol 9 no 1 article 77 2013

[11] H ul HassanWMurad A Tariq andA Ahmad ldquoEthnoveteri-nary study of medicinal plants in Malakand Valley District Dir(Lower) Khyber Pakhtunkhwa Pakistanrdquo Irish Veterinary Jour-nal vol 67 article 6 2014

[12] I Ilahi ldquoEthnobotanical studies and problems associated withregeneration of herbals in kohat regionrdquo Pakistan Journal ofBotany vol 40 no 4 pp 1743ndash1753 2008

[13] S Shinwari R Qureshi and E Baydoun ldquoEthnobotanical studyof Kohat Pass (Pakistan)rdquo Pakistan Journal Botany vol 43 pp135ndash139 2011

[14] F Hadi A Razzaq A Rahman and A Rashid ldquoEthnobotanicalnotes onwoody plants of RechValley TorkhowDistrict ChitralHindu-Kush range Pakistanrdquo Scholarly Journal of AgriculturalScience vol 3 no 11 pp 468ndash472 2013

[15] M Giday T Teklehaymanot A Animut and Y MekonnenldquoMedicinal plants of the Shinasha Agew-awi and Amharapeoples in northwest Ethiopiardquo Journal of Ethnopharmacologyvol 110 no 3 pp 516ndash525 2007

[16] R T Trotter and M H Logan ldquoInformants consensus a newapproach for identifying potentially effective medicinal plantsrdquoin Plants in Indigenous Medicine and Diet N L Etkin Ed pp91ndash112 Redgrave Bedford Hill NY USA 1986

BioMed Research International 9

[17] M Heinrich A Ankli B Frei C Weimann and O SticherldquoMedicinal plants in Mexico healersrsquo consensus and culturalimportancerdquo Social Science and Medicine vol 47 no 11 pp1859ndash1871 1998

[18] M Canales T Hernandez J Caballero et al ldquoInformantconsensus factor and antibacterial activity of the medicinalplants used by the people of San Rafael Coxcatlan PueblaMexicordquo Journal of Ethnopharmacology vol 97 no 3 pp 429ndash439 2005

[19] MKhan andFHussain ldquoConservation status of plant species inTehsil Takht-eNasrati District Karak Khyber PakhtunKhawaPakistanrdquo International Journal of Biodiversity and Conserva-tion vol 5 pp 20ndash26 2013

[20] N Khan M Ahmed A Ahmed et al ldquoImportant medicinalplants of Chitral Gol National Park (CGNP) Pakistanrdquo PakistanJournal of Botany vol 43 no 2 pp 797ndash809 2011

[21] CMuthuM Ayyanar N Raja and S Ignacimuthu ldquoMedicinalplants used by traditional healers in Kancheepuram District ofTamil Nadu Indiardquo Journal of Ethnobiology and Ethnomedicinevol 2 article 43 2006

[22] C P Kala ldquoEthnomedicinal botany of the Apatani in theEasternHimalayan region of Indiardquo Journal of Ethnobiology andEthnomedicine vol 1 article 11 2005

[23] AMaroyi ldquoTraditional use of medicinal plants in south-centralZimbabwe review and perspectivesrdquo Journal of Ethnobiologyand Ethnomedicne vol 9 article 31 2011

[24] M J Moshi D F Otieno and A Weisheit ldquoEthnomedicine ofthe Kagera Region north western Tanzania Part 3 plants usedin traditional medicine in Kikuku village Muleba DistrictrdquoJournal of Ethnobiology and Ethnomedicine vol 8 article 142012

[25] S B Padal Y Vijayakumar R J Butchi and P ChandrasekharldquoEthnomedicinal uses of Shrub species by tribals of BorraPanchayat Ananthagiri Mandalam Visakhapatnam districtAndhra Pradesh Indiardquo International Journal of PharmaceuticalScience Invention vol 2 pp 10ndash12 2013

[26] P Sharma C Malhotra D K Taneja and R Saha ldquoProblemsrelated to menstruation amongst adolescent girlsrdquo Indian Jour-nal of Pediatrics vol 75 no 2 pp 125ndash129 2008

[27] K Yamamoto A Okazaki Y Sakamoto and M Funatsu ldquoTherelationship between premenstrual symptoms menstrual painirregular menstrual cycles and psychosocial stress amongJapanese college studentsrdquo Journal of Physiological Anthropol-ogy vol 28 no 3 pp 129ndash136 2009

[28] J A Bhat M Kumar and R W Bussmann ldquoEcological statusand traditional knowledge of medicinal plants in KedarnathWildlife Sanctuary of Garhwal Himalaya Indiardquo Journal ofEthnobiology and Ethnomedicine vol 9 no 1 article 1 2013

Submit your manuscripts athttpwwwhindawicom

Stem CellsInternational

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

MEDIATORSINFLAMMATION

of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Behavioural Neurology

EndocrinologyInternational Journal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Disease Markers

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

BioMed Research International

OncologyJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Oxidative Medicine and Cellular Longevity

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

PPAR Research

The Scientific World JournalHindawi Publishing Corporation httpwwwhindawicom Volume 2014

Immunology ResearchHindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Journal of

ObesityJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Computational and Mathematical Methods in Medicine

OphthalmologyJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Diabetes ResearchJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Research and TreatmentAIDS

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Gastroenterology Research and Practice

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Parkinsonrsquos Disease

Evidence-Based Complementary and Alternative Medicine

Volume 2014Hindawi Publishing Corporationhttpwwwhindawicom

6 BioMed Research International

Table 2 General attributes of medicinal plants

Attribute Total number Percentage ()Part use

Leaves 16 313Whole plant 17 333Fruit 10 192Bark 6 115Root 5 96Stem 4 76Seed 4 76Flower 1 19

HabitHerb 31 59Shrub 7 134Trees 14 269

ReproductionAnnual 9 173Biennial 2 38Perennial 41 788

02468

101214161820

Num

ber o

f pla

nts

Abor

tion

Impo

tenc

y

Mas

titis

Leuc

orrh

oea

Abor

tifac

ient

Gyn

ae

Preg

nanc

y

Gon

orrh

ea

Men

ses

Gynaecological problems

Figure 3 Number of plants used to treat gynaecological problems

regions used different plant parts for the recipe preparationbut whole plant and leaves (33 and 31 resp) were foundto be the most frequent parts used against gynaecologicalcomplaints (Table 2) Nine types of gynaecological ailmentswere treated in study areas Majority of the plants (19) werefound to be used against menses followed by 11 plants eachfor gonorrhea and pregnancy related problems (Figure 3) Ficresults showed that all plants in different areas scored highconsensus ranges between 06 and 100 (Table 3) Majorityof the female respondents (44) were aged between 61 and70 years Total of 40 informants were illiterate followed by38 who had just primary level of education Majority of thefemales (86) interviewed were housewives followed by 14school teachers (Table 4)

4 Discussion

Present study results showed that women of studied remoteareas of Pakistan have strong traditional knowledge in theutilization of medicinal plants for variety of gynaecologi-cal disorders Traditionally the rural women prefer plantmedicines rather than modern medicine for their personalailments due to lack of modern facilities in the regionsAmong all studied regions Bannu was ranked first havinglarge number of gynaecological plants High number ofmedicinal plants in the region might be associated withthe prevalence of large number of gynaecological problemsin the Bannu region Nine types of ailments were foundtreated using ethnomedicines in Bannu region It is a waraffected region of Pakistan where traditional medicines useis a common practice [9] Karak and Malakand regions alsocontain considerable number of gynaecological plants due tothe greater plant diversity in the regions rural nature anddependency of women for their primary health care needs[11 19]

The women of the studied regions mostly use herbs(59) for the preparation of ethnomedicines followed bytrees (269) In most remote areas medicinal herbs arethe main ingredients of local medicines and consideredthe main lifeline and frequently first choice The highestuse of herbs gives an indication of the presence of greatabundance of herb species as noticed during field visits thatareas very close to houses were well covered with herbs andcenturies old traditional knowledge of the healers Commonuse of herbaceous plants has also been reported from otherregions of Pakistan [2 20] and parts of the world [21 22]Herbs can grow in variety of places like roadsides homegardens farmland wild habitats and foundmore common incomparison to other growth forms The highest tree speciesutilization might be associated with their potential to surviveeven during long dry seasons thus their abundance andavailability throughout the year is higher in arid and semiaridareas The findings are in line with some studies [10 23]while being contradictory with studies conducted elsewherewhere shrubs were more frequently used [24 25] Variationin medicinal plants growth form might be associated withdifferent sociocultural beliefs ecological status and variationin practices of traditional healers of different regions orcountries Women mostly use perennial plants (78) for thetreatment of gynaecological problems The reason behindusing perennial plants might be due to the fact that highnumber of herbs and trees in the studied regions are perennialin their reproduction status

Women of studied regions use reported medicinal plantsfor the treatment of nine types of gynaecological ailmentsMenses was found to be the most treated ailment in thestudied regions Total of 19 plants were used to treat mensesrelated problems followed by 11 plants each for gonorrhea andpregnancy 10 for gynae 6 for abortifacient 5 for leucorrheaand 2 plants each for mastitis and impotency and singleplant is used for abortion Higher plant utilization for mensesmight be due to natural phenomenon associated with varietyof complications such as abdominal or pelvic cramping

BioMed Research International 7

Table 3 Fic values of traditional medicinal plants for treating gynaecological problems in study regions

Gynaecological problems Bannu Karak Kohat Chitral Mansehra MalakandMenses 088 091 100 087 mdash 097Gonorrhea 091 093 083 mdash 092 092Mastitis 100 100 100 mdash mdash 100Pregnancy 094 081 mdash 090 072 072Leucorrhoea 091 096 082 mdash 092 100Abortion 100 mdash mdash mdash mdash mdashGynae 082 052 075 072 063 061Female impotency 091 093 mdash mdash 100 100

Table 4 Ethnographic data of study regions

Ethnographic characters Bannu Karak Malakand Chitral Mansehra Kohat PercentageAge groups

40ndash50 6 5 7 4 5 4 1051ndash60 15 12 13 12 10 10 2461ndash70 20 22 21 23 20 26 4471ndash80 9 11 9 11 15 10 22

EducationIlliterate 22 19 23 17 19 20 40Primary 18 22 20 14 19 19 38Middle 5 6 2 9 6 6 11Secondary 3 2 3 6 4 4 7University 2 1 2 4 2 1 4

OccupationHousewives 43 39 46 47 41 43 86Teachers 7 11 4 3 9 7 14

lower back pain bloating and sore breasts food cravingsmood swings and irritability headache and fatigue [2627] Different plants have been found effective in relievingmenses complications like Justicia adhatoda Schinus molleConvolvulus arvensis Cyperus rotundus and Hypericum per-foratum Rural women use different parts of plant to prepareethnomedicines however use of specific plant part dependsupon plant habit and user requirements Traditional healersmostly prefer leaves and whole plant for the formulation ofgynaecological recipes The selection of specific plant partssuggests that these parts have strong healing potential againstgynaecological disorders but these parts need phytochemicalscreening and pharmacological investigation in order tocross-check traditional knowledge Present findings are inline with other studies showing leaves and whole plants asthe most frequently used plant parts for the preparation ofdifferent ethnomedicines [21 22 28] Whole plant harvestingis considered a destructive type of harvesting and causespopulation reduction of plant species

Most of the plants were found used in more than oneregion for the same particular ailment for example Con-volvulus arvensis was used against menses complication inBannu Kohat Karak and Malakand Melia azadirachta wasfound to be effective against gonorrhea in Bannu and KarakSolanum surattense was being used against gonorrhea andpregnancy in Malakand Bannu and Kohat Such types of

resemblance using similar plants for the same type of ailmentsin different cultures or regions provide a strong signal ofbioactivity potential of the documented plant species Infor-mant consensus results showed high consensus values rangesbetween 06 and 100 for 9 disease categories in different areasHigh Fic values in these regions indicate high prevalence ofgiven gynaecological problems in these regions Accordingto Heinrich et al [17] high Fic values are very useful inthe selection of specific plants for further search of bioactivecompounds Most of the diseases were found to be treatedwith only one or two plants in the studied regions and theirFic score was also high 100 Such plants should furtherbe analyzed for their phytochemical and pharmacologicalinvestigation

Ethnographic data showed that majority of the females(44) interviewed were aged between 61 and 70 years Theseresults clearly indicate that traditional knowledge is restrictedto aged people in these regions due to least interest ofyounger generation Total of 40 informants were illiteratein these regions followed by 38 who had only primary levelof education Only 4 respondents had university level ofeducation which reflects the unavailability of standard edu-cational institutions in these areas Literate people had lessknowledge about medicinal plants as compared to illiteratepeople of the regions due to modernization and changing lifestyles Total of 86 women were housewives while only 14

8 BioMed Research International

of females were school teachers that might be due to the factthat in remote areas of Pakistan women are mostly confinedto homes due to variety of customs and religious restrictionsIn rural areas girls are supposed to be future wives mothersand housekeepers little attention is given to their formaleducation Rural women have little access to educationparticularly at higher levels Even at the primary and sec-ondary levels access is restricted retention rates are low andfacilities particularly in rural areas remain abysmal Womenare poorly represented in higher and technical education andthus have poor employment prospects The women do notget sufficient medical treatment due to unavailability of themedical facilities Low literacy rate lack of medical facilitiesand low income of the people are the main factors for theirgreater dependency on medicinal plants

5 Conclusions

The present study concluded that women in remote areasof Pakistan have great dependency on medicinal plants forthe treatment of different gynaecological problems Studiedregions contain considerable number of medicinal plantsused by the traditional healers in different herbal formu-lations Menses and gonorrhea were found to be the mostprevalent complications in the studied region Plants scoringhigh Fic value should be further evaluated for their phyto-chemical and pharmacological investigation Ethnogynaeco-logical knowledge is only restricted to aged women whileyoung generation is totally ignorant Young girls should beeducated regarding the importance of traditional knowledgeMoreover detailed studies on ethnogynaecological plantsshould be carried out before the extinction of this valuableknowledge

Conflict of Interests

The authors declare that there is no conflict of interestsregarding the publication of this paper

Authorsrsquo Contribution

Muhammad Adnan and Akash Tariq have designed theresearch project Akash Tariq Sakina Mussarat and ShaheenBegum conducted field work and collected ethnomedicinaldata After collection of data these authors analyzed the dataand prepared the whole paper Muhammad Adnan AkashTariq Riaz Ullah and Naser M AbdElsalam supervised allthe stages and provided comments on the draft All authorshave read and approved the final paper

Acknowledgments

The authors are thankful to the Deanship of Scientific Re-search King Saud University Riyadh Saudi Arabia for fund-ing the work through the Research Group Project no RGP-210 The authors offer special thanks to the local respondentsfor sharing their valuable knowledge

References

[1] B Sandhya S Thomas W Isabel and R Shenbagarathai ldquoEth-nomedical plants used by the Valaiyan community of Piran-malai Hills (Reserved Forest) Tamilnadu Indiamdasha pilot studyrdquoAfrican Journal of Traditional Complementary and AlternativeMedicines vol 3 no 1 pp 101ndash114 2006

[2] Z K Shinwari ldquoMedicinal plants research in Pakistanrdquo Journalof Medicinal Plant Research vol 4 pp 161ndash176 2010

[3] D C Deka V Kumar C Prasad et al ldquoOroxylum indicummdashamedicinal plant of North East India an overview of itsnutritional remedial and prophylactic propertiesrdquo Journal ofApplied Pharmaceutical Science vol 3 no 4 pp S104ndashS1122013

[4] E Nasir and S I Ali ldquoFlora of west Pakistanrdquo Tech Rep 1-190Pakistan Agriculture Research Council Islamabad Pakistan1971ndash1991

[5] A H M Rahman ldquoEthno-gynecological study of tradi-tional medicinal plants used by santals of Joypurhat DistrictBangladeshrdquo Biomedicine and Biotechnology vol 2 pp 10ndash132014

[6] C K Kaingu J A Oduma and T I Kanui ldquoPractices of tradi-tional birth attendants in Machakos District Kenyardquo Journal ofEthnopharmacology vol 137 no 1 pp 495ndash502 2011

[7] R A Qureshi M Ghufran S A Gilani A G Yousaf and ABatool ldquoIndigenous medicinal plants used by local women insouthern Himalayan regions of Pakistanrdquo Pakistan Journal ofBotany vol 41 no 1 pp 19ndash25 2009

[8] R B Tareen T Bibi M A Khan M Ahmad and M ZafarldquoIndigenous knowledge of folk medicine by the women of Kalatand Khuzdar regions of Balochistan Pakistanrdquo Pakistan Journalof Botany vol 42 no 3 pp 1465ndash1485 2010

[9] M Adnan I Ullah A Tariq et al ldquoEthnomedicine use in thewar affected region of northwest Pakistanrdquo Journal of Ethnobi-ology and Ethnomedicine vol 10 no 1 article 16 2014

[10] W Murad A Azizullah M Adnan et al ldquoEthnobotanicalassessment of plant resources of Banda Daud Shah DistrictKarak Pakistanrdquo Journal of Ethnobiology and Ethnomedicinevol 9 no 1 article 77 2013

[11] H ul HassanWMurad A Tariq andA Ahmad ldquoEthnoveteri-nary study of medicinal plants in Malakand Valley District Dir(Lower) Khyber Pakhtunkhwa Pakistanrdquo Irish Veterinary Jour-nal vol 67 article 6 2014

[12] I Ilahi ldquoEthnobotanical studies and problems associated withregeneration of herbals in kohat regionrdquo Pakistan Journal ofBotany vol 40 no 4 pp 1743ndash1753 2008

[13] S Shinwari R Qureshi and E Baydoun ldquoEthnobotanical studyof Kohat Pass (Pakistan)rdquo Pakistan Journal Botany vol 43 pp135ndash139 2011

[14] F Hadi A Razzaq A Rahman and A Rashid ldquoEthnobotanicalnotes onwoody plants of RechValley TorkhowDistrict ChitralHindu-Kush range Pakistanrdquo Scholarly Journal of AgriculturalScience vol 3 no 11 pp 468ndash472 2013

[15] M Giday T Teklehaymanot A Animut and Y MekonnenldquoMedicinal plants of the Shinasha Agew-awi and Amharapeoples in northwest Ethiopiardquo Journal of Ethnopharmacologyvol 110 no 3 pp 516ndash525 2007

[16] R T Trotter and M H Logan ldquoInformants consensus a newapproach for identifying potentially effective medicinal plantsrdquoin Plants in Indigenous Medicine and Diet N L Etkin Ed pp91ndash112 Redgrave Bedford Hill NY USA 1986

BioMed Research International 9

[17] M Heinrich A Ankli B Frei C Weimann and O SticherldquoMedicinal plants in Mexico healersrsquo consensus and culturalimportancerdquo Social Science and Medicine vol 47 no 11 pp1859ndash1871 1998

[18] M Canales T Hernandez J Caballero et al ldquoInformantconsensus factor and antibacterial activity of the medicinalplants used by the people of San Rafael Coxcatlan PueblaMexicordquo Journal of Ethnopharmacology vol 97 no 3 pp 429ndash439 2005

[19] MKhan andFHussain ldquoConservation status of plant species inTehsil Takht-eNasrati District Karak Khyber PakhtunKhawaPakistanrdquo International Journal of Biodiversity and Conserva-tion vol 5 pp 20ndash26 2013

[20] N Khan M Ahmed A Ahmed et al ldquoImportant medicinalplants of Chitral Gol National Park (CGNP) Pakistanrdquo PakistanJournal of Botany vol 43 no 2 pp 797ndash809 2011

[21] CMuthuM Ayyanar N Raja and S Ignacimuthu ldquoMedicinalplants used by traditional healers in Kancheepuram District ofTamil Nadu Indiardquo Journal of Ethnobiology and Ethnomedicinevol 2 article 43 2006

[22] C P Kala ldquoEthnomedicinal botany of the Apatani in theEasternHimalayan region of Indiardquo Journal of Ethnobiology andEthnomedicine vol 1 article 11 2005

[23] AMaroyi ldquoTraditional use of medicinal plants in south-centralZimbabwe review and perspectivesrdquo Journal of Ethnobiologyand Ethnomedicne vol 9 article 31 2011

[24] M J Moshi D F Otieno and A Weisheit ldquoEthnomedicine ofthe Kagera Region north western Tanzania Part 3 plants usedin traditional medicine in Kikuku village Muleba DistrictrdquoJournal of Ethnobiology and Ethnomedicine vol 8 article 142012

[25] S B Padal Y Vijayakumar R J Butchi and P ChandrasekharldquoEthnomedicinal uses of Shrub species by tribals of BorraPanchayat Ananthagiri Mandalam Visakhapatnam districtAndhra Pradesh Indiardquo International Journal of PharmaceuticalScience Invention vol 2 pp 10ndash12 2013

[26] P Sharma C Malhotra D K Taneja and R Saha ldquoProblemsrelated to menstruation amongst adolescent girlsrdquo Indian Jour-nal of Pediatrics vol 75 no 2 pp 125ndash129 2008

[27] K Yamamoto A Okazaki Y Sakamoto and M Funatsu ldquoTherelationship between premenstrual symptoms menstrual painirregular menstrual cycles and psychosocial stress amongJapanese college studentsrdquo Journal of Physiological Anthropol-ogy vol 28 no 3 pp 129ndash136 2009

[28] J A Bhat M Kumar and R W Bussmann ldquoEcological statusand traditional knowledge of medicinal plants in KedarnathWildlife Sanctuary of Garhwal Himalaya Indiardquo Journal ofEthnobiology and Ethnomedicine vol 9 no 1 article 1 2013

Submit your manuscripts athttpwwwhindawicom

Stem CellsInternational

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

MEDIATORSINFLAMMATION

of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Behavioural Neurology

EndocrinologyInternational Journal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Disease Markers

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

BioMed Research International

OncologyJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Oxidative Medicine and Cellular Longevity

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

PPAR Research

The Scientific World JournalHindawi Publishing Corporation httpwwwhindawicom Volume 2014

Immunology ResearchHindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Journal of

ObesityJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Computational and Mathematical Methods in Medicine

OphthalmologyJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Diabetes ResearchJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Research and TreatmentAIDS

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Gastroenterology Research and Practice

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Parkinsonrsquos Disease

Evidence-Based Complementary and Alternative Medicine

Volume 2014Hindawi Publishing Corporationhttpwwwhindawicom

BioMed Research International 7

Table 3 Fic values of traditional medicinal plants for treating gynaecological problems in study regions

Gynaecological problems Bannu Karak Kohat Chitral Mansehra MalakandMenses 088 091 100 087 mdash 097Gonorrhea 091 093 083 mdash 092 092Mastitis 100 100 100 mdash mdash 100Pregnancy 094 081 mdash 090 072 072Leucorrhoea 091 096 082 mdash 092 100Abortion 100 mdash mdash mdash mdash mdashGynae 082 052 075 072 063 061Female impotency 091 093 mdash mdash 100 100

Table 4 Ethnographic data of study regions

Ethnographic characters Bannu Karak Malakand Chitral Mansehra Kohat PercentageAge groups

40ndash50 6 5 7 4 5 4 1051ndash60 15 12 13 12 10 10 2461ndash70 20 22 21 23 20 26 4471ndash80 9 11 9 11 15 10 22

EducationIlliterate 22 19 23 17 19 20 40Primary 18 22 20 14 19 19 38Middle 5 6 2 9 6 6 11Secondary 3 2 3 6 4 4 7University 2 1 2 4 2 1 4

OccupationHousewives 43 39 46 47 41 43 86Teachers 7 11 4 3 9 7 14

lower back pain bloating and sore breasts food cravingsmood swings and irritability headache and fatigue [2627] Different plants have been found effective in relievingmenses complications like Justicia adhatoda Schinus molleConvolvulus arvensis Cyperus rotundus and Hypericum per-foratum Rural women use different parts of plant to prepareethnomedicines however use of specific plant part dependsupon plant habit and user requirements Traditional healersmostly prefer leaves and whole plant for the formulation ofgynaecological recipes The selection of specific plant partssuggests that these parts have strong healing potential againstgynaecological disorders but these parts need phytochemicalscreening and pharmacological investigation in order tocross-check traditional knowledge Present findings are inline with other studies showing leaves and whole plants asthe most frequently used plant parts for the preparation ofdifferent ethnomedicines [21 22 28] Whole plant harvestingis considered a destructive type of harvesting and causespopulation reduction of plant species

Most of the plants were found used in more than oneregion for the same particular ailment for example Con-volvulus arvensis was used against menses complication inBannu Kohat Karak and Malakand Melia azadirachta wasfound to be effective against gonorrhea in Bannu and KarakSolanum surattense was being used against gonorrhea andpregnancy in Malakand Bannu and Kohat Such types of

resemblance using similar plants for the same type of ailmentsin different cultures or regions provide a strong signal ofbioactivity potential of the documented plant species Infor-mant consensus results showed high consensus values rangesbetween 06 and 100 for 9 disease categories in different areasHigh Fic values in these regions indicate high prevalence ofgiven gynaecological problems in these regions Accordingto Heinrich et al [17] high Fic values are very useful inthe selection of specific plants for further search of bioactivecompounds Most of the diseases were found to be treatedwith only one or two plants in the studied regions and theirFic score was also high 100 Such plants should furtherbe analyzed for their phytochemical and pharmacologicalinvestigation

Ethnographic data showed that majority of the females(44) interviewed were aged between 61 and 70 years Theseresults clearly indicate that traditional knowledge is restrictedto aged people in these regions due to least interest ofyounger generation Total of 40 informants were illiteratein these regions followed by 38 who had only primary levelof education Only 4 respondents had university level ofeducation which reflects the unavailability of standard edu-cational institutions in these areas Literate people had lessknowledge about medicinal plants as compared to illiteratepeople of the regions due to modernization and changing lifestyles Total of 86 women were housewives while only 14

8 BioMed Research International

of females were school teachers that might be due to the factthat in remote areas of Pakistan women are mostly confinedto homes due to variety of customs and religious restrictionsIn rural areas girls are supposed to be future wives mothersand housekeepers little attention is given to their formaleducation Rural women have little access to educationparticularly at higher levels Even at the primary and sec-ondary levels access is restricted retention rates are low andfacilities particularly in rural areas remain abysmal Womenare poorly represented in higher and technical education andthus have poor employment prospects The women do notget sufficient medical treatment due to unavailability of themedical facilities Low literacy rate lack of medical facilitiesand low income of the people are the main factors for theirgreater dependency on medicinal plants

5 Conclusions

The present study concluded that women in remote areasof Pakistan have great dependency on medicinal plants forthe treatment of different gynaecological problems Studiedregions contain considerable number of medicinal plantsused by the traditional healers in different herbal formu-lations Menses and gonorrhea were found to be the mostprevalent complications in the studied region Plants scoringhigh Fic value should be further evaluated for their phyto-chemical and pharmacological investigation Ethnogynaeco-logical knowledge is only restricted to aged women whileyoung generation is totally ignorant Young girls should beeducated regarding the importance of traditional knowledgeMoreover detailed studies on ethnogynaecological plantsshould be carried out before the extinction of this valuableknowledge

Conflict of Interests

The authors declare that there is no conflict of interestsregarding the publication of this paper

Authorsrsquo Contribution

Muhammad Adnan and Akash Tariq have designed theresearch project Akash Tariq Sakina Mussarat and ShaheenBegum conducted field work and collected ethnomedicinaldata After collection of data these authors analyzed the dataand prepared the whole paper Muhammad Adnan AkashTariq Riaz Ullah and Naser M AbdElsalam supervised allthe stages and provided comments on the draft All authorshave read and approved the final paper

Acknowledgments

The authors are thankful to the Deanship of Scientific Re-search King Saud University Riyadh Saudi Arabia for fund-ing the work through the Research Group Project no RGP-210 The authors offer special thanks to the local respondentsfor sharing their valuable knowledge

References

[1] B Sandhya S Thomas W Isabel and R Shenbagarathai ldquoEth-nomedical plants used by the Valaiyan community of Piran-malai Hills (Reserved Forest) Tamilnadu Indiamdasha pilot studyrdquoAfrican Journal of Traditional Complementary and AlternativeMedicines vol 3 no 1 pp 101ndash114 2006

[2] Z K Shinwari ldquoMedicinal plants research in Pakistanrdquo Journalof Medicinal Plant Research vol 4 pp 161ndash176 2010

[3] D C Deka V Kumar C Prasad et al ldquoOroxylum indicummdashamedicinal plant of North East India an overview of itsnutritional remedial and prophylactic propertiesrdquo Journal ofApplied Pharmaceutical Science vol 3 no 4 pp S104ndashS1122013

[4] E Nasir and S I Ali ldquoFlora of west Pakistanrdquo Tech Rep 1-190Pakistan Agriculture Research Council Islamabad Pakistan1971ndash1991

[5] A H M Rahman ldquoEthno-gynecological study of tradi-tional medicinal plants used by santals of Joypurhat DistrictBangladeshrdquo Biomedicine and Biotechnology vol 2 pp 10ndash132014

[6] C K Kaingu J A Oduma and T I Kanui ldquoPractices of tradi-tional birth attendants in Machakos District Kenyardquo Journal ofEthnopharmacology vol 137 no 1 pp 495ndash502 2011

[7] R A Qureshi M Ghufran S A Gilani A G Yousaf and ABatool ldquoIndigenous medicinal plants used by local women insouthern Himalayan regions of Pakistanrdquo Pakistan Journal ofBotany vol 41 no 1 pp 19ndash25 2009

[8] R B Tareen T Bibi M A Khan M Ahmad and M ZafarldquoIndigenous knowledge of folk medicine by the women of Kalatand Khuzdar regions of Balochistan Pakistanrdquo Pakistan Journalof Botany vol 42 no 3 pp 1465ndash1485 2010

[9] M Adnan I Ullah A Tariq et al ldquoEthnomedicine use in thewar affected region of northwest Pakistanrdquo Journal of Ethnobi-ology and Ethnomedicine vol 10 no 1 article 16 2014

[10] W Murad A Azizullah M Adnan et al ldquoEthnobotanicalassessment of plant resources of Banda Daud Shah DistrictKarak Pakistanrdquo Journal of Ethnobiology and Ethnomedicinevol 9 no 1 article 77 2013

[11] H ul HassanWMurad A Tariq andA Ahmad ldquoEthnoveteri-nary study of medicinal plants in Malakand Valley District Dir(Lower) Khyber Pakhtunkhwa Pakistanrdquo Irish Veterinary Jour-nal vol 67 article 6 2014

[12] I Ilahi ldquoEthnobotanical studies and problems associated withregeneration of herbals in kohat regionrdquo Pakistan Journal ofBotany vol 40 no 4 pp 1743ndash1753 2008

[13] S Shinwari R Qureshi and E Baydoun ldquoEthnobotanical studyof Kohat Pass (Pakistan)rdquo Pakistan Journal Botany vol 43 pp135ndash139 2011

[14] F Hadi A Razzaq A Rahman and A Rashid ldquoEthnobotanicalnotes onwoody plants of RechValley TorkhowDistrict ChitralHindu-Kush range Pakistanrdquo Scholarly Journal of AgriculturalScience vol 3 no 11 pp 468ndash472 2013

[15] M Giday T Teklehaymanot A Animut and Y MekonnenldquoMedicinal plants of the Shinasha Agew-awi and Amharapeoples in northwest Ethiopiardquo Journal of Ethnopharmacologyvol 110 no 3 pp 516ndash525 2007

[16] R T Trotter and M H Logan ldquoInformants consensus a newapproach for identifying potentially effective medicinal plantsrdquoin Plants in Indigenous Medicine and Diet N L Etkin Ed pp91ndash112 Redgrave Bedford Hill NY USA 1986

BioMed Research International 9

[17] M Heinrich A Ankli B Frei C Weimann and O SticherldquoMedicinal plants in Mexico healersrsquo consensus and culturalimportancerdquo Social Science and Medicine vol 47 no 11 pp1859ndash1871 1998

[18] M Canales T Hernandez J Caballero et al ldquoInformantconsensus factor and antibacterial activity of the medicinalplants used by the people of San Rafael Coxcatlan PueblaMexicordquo Journal of Ethnopharmacology vol 97 no 3 pp 429ndash439 2005

[19] MKhan andFHussain ldquoConservation status of plant species inTehsil Takht-eNasrati District Karak Khyber PakhtunKhawaPakistanrdquo International Journal of Biodiversity and Conserva-tion vol 5 pp 20ndash26 2013

[20] N Khan M Ahmed A Ahmed et al ldquoImportant medicinalplants of Chitral Gol National Park (CGNP) Pakistanrdquo PakistanJournal of Botany vol 43 no 2 pp 797ndash809 2011

[21] CMuthuM Ayyanar N Raja and S Ignacimuthu ldquoMedicinalplants used by traditional healers in Kancheepuram District ofTamil Nadu Indiardquo Journal of Ethnobiology and Ethnomedicinevol 2 article 43 2006

[22] C P Kala ldquoEthnomedicinal botany of the Apatani in theEasternHimalayan region of Indiardquo Journal of Ethnobiology andEthnomedicine vol 1 article 11 2005

[23] AMaroyi ldquoTraditional use of medicinal plants in south-centralZimbabwe review and perspectivesrdquo Journal of Ethnobiologyand Ethnomedicne vol 9 article 31 2011

[24] M J Moshi D F Otieno and A Weisheit ldquoEthnomedicine ofthe Kagera Region north western Tanzania Part 3 plants usedin traditional medicine in Kikuku village Muleba DistrictrdquoJournal of Ethnobiology and Ethnomedicine vol 8 article 142012

[25] S B Padal Y Vijayakumar R J Butchi and P ChandrasekharldquoEthnomedicinal uses of Shrub species by tribals of BorraPanchayat Ananthagiri Mandalam Visakhapatnam districtAndhra Pradesh Indiardquo International Journal of PharmaceuticalScience Invention vol 2 pp 10ndash12 2013

[26] P Sharma C Malhotra D K Taneja and R Saha ldquoProblemsrelated to menstruation amongst adolescent girlsrdquo Indian Jour-nal of Pediatrics vol 75 no 2 pp 125ndash129 2008

[27] K Yamamoto A Okazaki Y Sakamoto and M Funatsu ldquoTherelationship between premenstrual symptoms menstrual painirregular menstrual cycles and psychosocial stress amongJapanese college studentsrdquo Journal of Physiological Anthropol-ogy vol 28 no 3 pp 129ndash136 2009

[28] J A Bhat M Kumar and R W Bussmann ldquoEcological statusand traditional knowledge of medicinal plants in KedarnathWildlife Sanctuary of Garhwal Himalaya Indiardquo Journal ofEthnobiology and Ethnomedicine vol 9 no 1 article 1 2013

Submit your manuscripts athttpwwwhindawicom

Stem CellsInternational

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

MEDIATORSINFLAMMATION

of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Behavioural Neurology

EndocrinologyInternational Journal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Disease Markers

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

BioMed Research International

OncologyJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Oxidative Medicine and Cellular Longevity

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

PPAR Research

The Scientific World JournalHindawi Publishing Corporation httpwwwhindawicom Volume 2014

Immunology ResearchHindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Journal of

ObesityJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Computational and Mathematical Methods in Medicine

OphthalmologyJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Diabetes ResearchJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Research and TreatmentAIDS

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Gastroenterology Research and Practice

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Parkinsonrsquos Disease

Evidence-Based Complementary and Alternative Medicine

Volume 2014Hindawi Publishing Corporationhttpwwwhindawicom

8 BioMed Research International

of females were school teachers that might be due to the factthat in remote areas of Pakistan women are mostly confinedto homes due to variety of customs and religious restrictionsIn rural areas girls are supposed to be future wives mothersand housekeepers little attention is given to their formaleducation Rural women have little access to educationparticularly at higher levels Even at the primary and sec-ondary levels access is restricted retention rates are low andfacilities particularly in rural areas remain abysmal Womenare poorly represented in higher and technical education andthus have poor employment prospects The women do notget sufficient medical treatment due to unavailability of themedical facilities Low literacy rate lack of medical facilitiesand low income of the people are the main factors for theirgreater dependency on medicinal plants

5 Conclusions

The present study concluded that women in remote areasof Pakistan have great dependency on medicinal plants forthe treatment of different gynaecological problems Studiedregions contain considerable number of medicinal plantsused by the traditional healers in different herbal formu-lations Menses and gonorrhea were found to be the mostprevalent complications in the studied region Plants scoringhigh Fic value should be further evaluated for their phyto-chemical and pharmacological investigation Ethnogynaeco-logical knowledge is only restricted to aged women whileyoung generation is totally ignorant Young girls should beeducated regarding the importance of traditional knowledgeMoreover detailed studies on ethnogynaecological plantsshould be carried out before the extinction of this valuableknowledge

Conflict of Interests

The authors declare that there is no conflict of interestsregarding the publication of this paper

Authorsrsquo Contribution

Muhammad Adnan and Akash Tariq have designed theresearch project Akash Tariq Sakina Mussarat and ShaheenBegum conducted field work and collected ethnomedicinaldata After collection of data these authors analyzed the dataand prepared the whole paper Muhammad Adnan AkashTariq Riaz Ullah and Naser M AbdElsalam supervised allthe stages and provided comments on the draft All authorshave read and approved the final paper

Acknowledgments

The authors are thankful to the Deanship of Scientific Re-search King Saud University Riyadh Saudi Arabia for fund-ing the work through the Research Group Project no RGP-210 The authors offer special thanks to the local respondentsfor sharing their valuable knowledge

References

[1] B Sandhya S Thomas W Isabel and R Shenbagarathai ldquoEth-nomedical plants used by the Valaiyan community of Piran-malai Hills (Reserved Forest) Tamilnadu Indiamdasha pilot studyrdquoAfrican Journal of Traditional Complementary and AlternativeMedicines vol 3 no 1 pp 101ndash114 2006

[2] Z K Shinwari ldquoMedicinal plants research in Pakistanrdquo Journalof Medicinal Plant Research vol 4 pp 161ndash176 2010

[3] D C Deka V Kumar C Prasad et al ldquoOroxylum indicummdashamedicinal plant of North East India an overview of itsnutritional remedial and prophylactic propertiesrdquo Journal ofApplied Pharmaceutical Science vol 3 no 4 pp S104ndashS1122013

[4] E Nasir and S I Ali ldquoFlora of west Pakistanrdquo Tech Rep 1-190Pakistan Agriculture Research Council Islamabad Pakistan1971ndash1991

[5] A H M Rahman ldquoEthno-gynecological study of tradi-tional medicinal plants used by santals of Joypurhat DistrictBangladeshrdquo Biomedicine and Biotechnology vol 2 pp 10ndash132014

[6] C K Kaingu J A Oduma and T I Kanui ldquoPractices of tradi-tional birth attendants in Machakos District Kenyardquo Journal ofEthnopharmacology vol 137 no 1 pp 495ndash502 2011

[7] R A Qureshi M Ghufran S A Gilani A G Yousaf and ABatool ldquoIndigenous medicinal plants used by local women insouthern Himalayan regions of Pakistanrdquo Pakistan Journal ofBotany vol 41 no 1 pp 19ndash25 2009

[8] R B Tareen T Bibi M A Khan M Ahmad and M ZafarldquoIndigenous knowledge of folk medicine by the women of Kalatand Khuzdar regions of Balochistan Pakistanrdquo Pakistan Journalof Botany vol 42 no 3 pp 1465ndash1485 2010

[9] M Adnan I Ullah A Tariq et al ldquoEthnomedicine use in thewar affected region of northwest Pakistanrdquo Journal of Ethnobi-ology and Ethnomedicine vol 10 no 1 article 16 2014

[10] W Murad A Azizullah M Adnan et al ldquoEthnobotanicalassessment of plant resources of Banda Daud Shah DistrictKarak Pakistanrdquo Journal of Ethnobiology and Ethnomedicinevol 9 no 1 article 77 2013

[11] H ul HassanWMurad A Tariq andA Ahmad ldquoEthnoveteri-nary study of medicinal plants in Malakand Valley District Dir(Lower) Khyber Pakhtunkhwa Pakistanrdquo Irish Veterinary Jour-nal vol 67 article 6 2014

[12] I Ilahi ldquoEthnobotanical studies and problems associated withregeneration of herbals in kohat regionrdquo Pakistan Journal ofBotany vol 40 no 4 pp 1743ndash1753 2008

[13] S Shinwari R Qureshi and E Baydoun ldquoEthnobotanical studyof Kohat Pass (Pakistan)rdquo Pakistan Journal Botany vol 43 pp135ndash139 2011

[14] F Hadi A Razzaq A Rahman and A Rashid ldquoEthnobotanicalnotes onwoody plants of RechValley TorkhowDistrict ChitralHindu-Kush range Pakistanrdquo Scholarly Journal of AgriculturalScience vol 3 no 11 pp 468ndash472 2013

[15] M Giday T Teklehaymanot A Animut and Y MekonnenldquoMedicinal plants of the Shinasha Agew-awi and Amharapeoples in northwest Ethiopiardquo Journal of Ethnopharmacologyvol 110 no 3 pp 516ndash525 2007

[16] R T Trotter and M H Logan ldquoInformants consensus a newapproach for identifying potentially effective medicinal plantsrdquoin Plants in Indigenous Medicine and Diet N L Etkin Ed pp91ndash112 Redgrave Bedford Hill NY USA 1986

BioMed Research International 9

[17] M Heinrich A Ankli B Frei C Weimann and O SticherldquoMedicinal plants in Mexico healersrsquo consensus and culturalimportancerdquo Social Science and Medicine vol 47 no 11 pp1859ndash1871 1998

[18] M Canales T Hernandez J Caballero et al ldquoInformantconsensus factor and antibacterial activity of the medicinalplants used by the people of San Rafael Coxcatlan PueblaMexicordquo Journal of Ethnopharmacology vol 97 no 3 pp 429ndash439 2005

[19] MKhan andFHussain ldquoConservation status of plant species inTehsil Takht-eNasrati District Karak Khyber PakhtunKhawaPakistanrdquo International Journal of Biodiversity and Conserva-tion vol 5 pp 20ndash26 2013

[20] N Khan M Ahmed A Ahmed et al ldquoImportant medicinalplants of Chitral Gol National Park (CGNP) Pakistanrdquo PakistanJournal of Botany vol 43 no 2 pp 797ndash809 2011

[21] CMuthuM Ayyanar N Raja and S Ignacimuthu ldquoMedicinalplants used by traditional healers in Kancheepuram District ofTamil Nadu Indiardquo Journal of Ethnobiology and Ethnomedicinevol 2 article 43 2006

[22] C P Kala ldquoEthnomedicinal botany of the Apatani in theEasternHimalayan region of Indiardquo Journal of Ethnobiology andEthnomedicine vol 1 article 11 2005

[23] AMaroyi ldquoTraditional use of medicinal plants in south-centralZimbabwe review and perspectivesrdquo Journal of Ethnobiologyand Ethnomedicne vol 9 article 31 2011

[24] M J Moshi D F Otieno and A Weisheit ldquoEthnomedicine ofthe Kagera Region north western Tanzania Part 3 plants usedin traditional medicine in Kikuku village Muleba DistrictrdquoJournal of Ethnobiology and Ethnomedicine vol 8 article 142012

[25] S B Padal Y Vijayakumar R J Butchi and P ChandrasekharldquoEthnomedicinal uses of Shrub species by tribals of BorraPanchayat Ananthagiri Mandalam Visakhapatnam districtAndhra Pradesh Indiardquo International Journal of PharmaceuticalScience Invention vol 2 pp 10ndash12 2013

[26] P Sharma C Malhotra D K Taneja and R Saha ldquoProblemsrelated to menstruation amongst adolescent girlsrdquo Indian Jour-nal of Pediatrics vol 75 no 2 pp 125ndash129 2008

[27] K Yamamoto A Okazaki Y Sakamoto and M Funatsu ldquoTherelationship between premenstrual symptoms menstrual painirregular menstrual cycles and psychosocial stress amongJapanese college studentsrdquo Journal of Physiological Anthropol-ogy vol 28 no 3 pp 129ndash136 2009

[28] J A Bhat M Kumar and R W Bussmann ldquoEcological statusand traditional knowledge of medicinal plants in KedarnathWildlife Sanctuary of Garhwal Himalaya Indiardquo Journal ofEthnobiology and Ethnomedicine vol 9 no 1 article 1 2013

Submit your manuscripts athttpwwwhindawicom

Stem CellsInternational

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

MEDIATORSINFLAMMATION

of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Behavioural Neurology

EndocrinologyInternational Journal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Disease Markers

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

BioMed Research International

OncologyJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Oxidative Medicine and Cellular Longevity

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

PPAR Research

The Scientific World JournalHindawi Publishing Corporation httpwwwhindawicom Volume 2014

Immunology ResearchHindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Journal of

ObesityJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Computational and Mathematical Methods in Medicine

OphthalmologyJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Diabetes ResearchJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Research and TreatmentAIDS

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Gastroenterology Research and Practice

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Parkinsonrsquos Disease

Evidence-Based Complementary and Alternative Medicine

Volume 2014Hindawi Publishing Corporationhttpwwwhindawicom

BioMed Research International 9

[17] M Heinrich A Ankli B Frei C Weimann and O SticherldquoMedicinal plants in Mexico healersrsquo consensus and culturalimportancerdquo Social Science and Medicine vol 47 no 11 pp1859ndash1871 1998

[18] M Canales T Hernandez J Caballero et al ldquoInformantconsensus factor and antibacterial activity of the medicinalplants used by the people of San Rafael Coxcatlan PueblaMexicordquo Journal of Ethnopharmacology vol 97 no 3 pp 429ndash439 2005

[19] MKhan andFHussain ldquoConservation status of plant species inTehsil Takht-eNasrati District Karak Khyber PakhtunKhawaPakistanrdquo International Journal of Biodiversity and Conserva-tion vol 5 pp 20ndash26 2013

[20] N Khan M Ahmed A Ahmed et al ldquoImportant medicinalplants of Chitral Gol National Park (CGNP) Pakistanrdquo PakistanJournal of Botany vol 43 no 2 pp 797ndash809 2011

[21] CMuthuM Ayyanar N Raja and S Ignacimuthu ldquoMedicinalplants used by traditional healers in Kancheepuram District ofTamil Nadu Indiardquo Journal of Ethnobiology and Ethnomedicinevol 2 article 43 2006

[22] C P Kala ldquoEthnomedicinal botany of the Apatani in theEasternHimalayan region of Indiardquo Journal of Ethnobiology andEthnomedicine vol 1 article 11 2005

[23] AMaroyi ldquoTraditional use of medicinal plants in south-centralZimbabwe review and perspectivesrdquo Journal of Ethnobiologyand Ethnomedicne vol 9 article 31 2011

[24] M J Moshi D F Otieno and A Weisheit ldquoEthnomedicine ofthe Kagera Region north western Tanzania Part 3 plants usedin traditional medicine in Kikuku village Muleba DistrictrdquoJournal of Ethnobiology and Ethnomedicine vol 8 article 142012

[25] S B Padal Y Vijayakumar R J Butchi and P ChandrasekharldquoEthnomedicinal uses of Shrub species by tribals of BorraPanchayat Ananthagiri Mandalam Visakhapatnam districtAndhra Pradesh Indiardquo International Journal of PharmaceuticalScience Invention vol 2 pp 10ndash12 2013

[26] P Sharma C Malhotra D K Taneja and R Saha ldquoProblemsrelated to menstruation amongst adolescent girlsrdquo Indian Jour-nal of Pediatrics vol 75 no 2 pp 125ndash129 2008

[27] K Yamamoto A Okazaki Y Sakamoto and M Funatsu ldquoTherelationship between premenstrual symptoms menstrual painirregular menstrual cycles and psychosocial stress amongJapanese college studentsrdquo Journal of Physiological Anthropol-ogy vol 28 no 3 pp 129ndash136 2009

[28] J A Bhat M Kumar and R W Bussmann ldquoEcological statusand traditional knowledge of medicinal plants in KedarnathWildlife Sanctuary of Garhwal Himalaya Indiardquo Journal ofEthnobiology and Ethnomedicine vol 9 no 1 article 1 2013

Submit your manuscripts athttpwwwhindawicom

Stem CellsInternational

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

MEDIATORSINFLAMMATION

of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Behavioural Neurology

EndocrinologyInternational Journal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Disease Markers

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

BioMed Research International

OncologyJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Oxidative Medicine and Cellular Longevity

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

PPAR Research

The Scientific World JournalHindawi Publishing Corporation httpwwwhindawicom Volume 2014

Immunology ResearchHindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Journal of

ObesityJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Computational and Mathematical Methods in Medicine

OphthalmologyJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Diabetes ResearchJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Research and TreatmentAIDS

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Gastroenterology Research and Practice

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Parkinsonrsquos Disease

Evidence-Based Complementary and Alternative Medicine

Volume 2014Hindawi Publishing Corporationhttpwwwhindawicom

Submit your manuscripts athttpwwwhindawicom

Stem CellsInternational

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

MEDIATORSINFLAMMATION

of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Behavioural Neurology

EndocrinologyInternational Journal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Disease Markers

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

BioMed Research International

OncologyJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Oxidative Medicine and Cellular Longevity

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

PPAR Research

The Scientific World JournalHindawi Publishing Corporation httpwwwhindawicom Volume 2014

Immunology ResearchHindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Journal of

ObesityJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Computational and Mathematical Methods in Medicine

OphthalmologyJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Diabetes ResearchJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Research and TreatmentAIDS

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Gastroenterology Research and Practice

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Parkinsonrsquos Disease

Evidence-Based Complementary and Alternative Medicine

Volume 2014Hindawi Publishing Corporationhttpwwwhindawicom