The traditional medicinal usage of plants for curing human ailments is vital to indigenous communities in the northern parts of Pakistan, which is considered valuable local sociocultural heritage [8]. Our study conducted a survey with the local community evaluating the plants, the mode and parts that are used, and for which treatment these plants are indicated. This is the first study related to ethnobotany in this area, which is fundamental for the advancement of folk medicine and for the knowledge and survey of all vegetation used by local communities.

We found a total of 27 plant species belonging to 18 families: 70% herbs, 26% shrubs, and 4% trees, which were administered by the locals for various health issues. As we can see, herbs were the most commonly used type of plant to treat diseases in local medicine. We can link this high use of herbs to the representativeness of this plant growth form in these areas. Many researchers mentioned herbaceous growth form as the dominant plant habit [5,9], which may influence the potential use of these plants to treat diseases. In addition, Asteraceae, Lamiaceae, and Fabaceae were the leading families used in the medication of 21 diseases. Some studies have mentioned Asteraceae as the leading family with the maximum number of plants species for curing diseases [10,11]. For instance, Kumar et al. [12] also reported Asteraceae and Fabaceae as the most significant source of ingredients in traditional folk recipes.

The local inhabitants and traditional healers use medicinal plant species for treating 21 different diseases. Out of these, diarrhea and gas trouble were the most treated diseases with five plant species each, followed by diuretic with four species, and cough and indigestion with three species each. Stomach and intestinal disorders, as well as cough, are more frequent diseases and generally have a greater knowledge of their treatment by the local community [13]. The local inhabitants most widely used leaves to cure diseases (36%), followed by the whole plant (22%). Leaves are known to have various chemical compounds, which are mainly used as a defense against herbivores [14]. However, these chemical compounds may be beneficial for treating disease, as shown in several studies [5,15]. For instance, Ijaz et al. [15] cited leaves as the most useful phyto-part in medicinal values. Furthermore, Luitel et al. [14] reported that most of the diseases were treated orally. Uses of the plants and their parts by rural inhabitants are common because there is no alternative facility to avail in such remote valleys [6]; as such cultural knowledge is intricately linked to local culture, religion, and history [16].

Dominant medicinal plants with the highest use value were Cannabis sativa having UVi = 0.97, Mentha longifolia and Plantago major (0.90 each), Cichorium intybus and Oxalis corniculata (0.86 each). The maximum use value of reported medicinal plants may indicate their common distribution and/or local practitioner’s expertise, which leads to a priority of choice for ailments [6,17]. In addition, the most valuable and cited medicinal plant species were Mentha longifolia having RFCs = 0.65, Cannabis sativa (0.58), and Oxalis corniculata (0.56). The maximum RFCs reveals that the reported plants are much familiar to the number of local informants and herbal practitioners [17]. Medicinal plants with high UVi and RFCs may indicate high abundance at the region, presence of important active compounds for the treatment of diseases, or even high concentrations of certain active compounds. In this context, these plants should be further evaluated phytochemically to analyze and identify active compounds for potential drug discovery [5].

Medicinal plants had a high fidelity level and were reported for single or few medications. These plant species have revealed remarkable medicinal significance, and further assessment through phytochemical, biological, and pharmaceutical activities is important. On an experimental basis, many researchers obtained maximum fidelity level values against oral disorders [18]. Nonetheless, minimum FL may not be abundant, and this highlights the importance of securing these plant species for future generations, as threats of gradual depletion to the extinction of cultural knowledge are rising [19].

The literature has revealed that most plants have chemical compounds and play a vital role in biological activities. For example, Cannabis sativa contains important compounds such as alkaloids, cannabinoids, cardiac glycosides, flavonoids, resins, steroids, tetrahydrocannabinol, and cannabidiol. This plant also has significant potential in analgesic, anti-emetic, anti-inflammatory, sedative, anti-convulsive, and laxative actions [7]. Also, Cannabis sativa seed oil hepatoprotective and toxicity was also assessed in albino rat, and its safe dosage was also reported [20], showing the potential that the compounds of this plant have for the treatment of diseases. Several other plants have a cocktail of chemical compounds that have active potential against various other diseases, which has been reported in several studies [21,22,23,24,25,26,27]. For instance, Mentha longifolia contains anthraquinones, flavonoids, glycosides, lignin, phenolic compounds, saponins, tannins, terpenoids [21]; Plantago major contains alkaloid, carbohydrates, coumarin, proteins, glycoside, glycosids, tannins, triterpens [22]; Cichorium intybus contains alkaloids, blumeatin, coumarins, diosmetin, dihydroquercetin 7-4′-dimethyl ether, esculetin, flavonoids, glycosides, which have a positive potential as for anti-oxidant, anti-tyrosinase, and anti-bacterial activities [23]. Ricinus communis has been reported as an important medicinal plant species in numerous studies, such as purgative, lubricant [28], bowels [29], leg sore, piles, edema [30], purgative, anti-flatulent, anti-inflammatory, analgesic, laxative, diarrhea [13], rheumatic joints, swellings, muscular inflammation, and toothache [31]. Other studies have also shown active plant compounds with the disease they are linked [32,33,34,35,36,37,38,39,40] Although, scientific evidence and proper experimentation for safe or recommended doses as well as lethal and harmful toxicities for most of these species are currently unavailable.

Comparative analyses of data use of plants for medicinal purposes of this study and published data from regional, national, and global levels based on SQ% and RSI% showed 0% to 27.12% and 0% to 6.78% similarity, respectively. After a cross-cultural comparative analysis of the reported taxa, very fewer similarities were found, and this might indicate the importance of geographical variations. The analytical approach of Sorensen’s similarity index determines only the common floral similarity by comparison of a case study with previous documentation but does not address the common plants with similar use(s) (Table S1). Our comparative results have 27.12% similarity with Qureshi et al. [28] from Abbottabad, Northern Pakistan, 26.42% with Akhtar et al. [29] from Swat, North Pakistan, 24.39% with Ijaz et al. [5] from Abbottabad, Pakistan, 19.47% with Matin et al. [41] from Shogran, Mansehra, Pakistan and 18.35% with Khan et al. [42] from Naran Valley, Pakistan (Table S1). Moreover, the remaining 16 studies similarities ranged from 0% to 18.37%, and out of these, four studies showed 0% similarity to Siran Valley, Mansehra, Pakistan [43], Deosai Plateau, Gilgit Baltistan, Pakistan [44], Aladaglar, Nigde-Turkey [45]. On the other hand, the highest degree of similarity index of the present study was found with a study conducted in Abbottabad, Pakistan, by Qureshi et al. [28] with RSI = 6.78%. In comparison, we found an RSI value of 0% with 10 previous studies, and out of these seven studies that had common plant species, no single common plant species has been cited for common medicinal use(s), which is why RSI showed 0% similarity [13,23,31,43,44,45,46,47,48,49] (Table S1). A cross-cultural analysis of the reported taxa assessed through the RSI% index revealed novel findings and new reports of medicinal plant species used for curing various diseases.

The cited medicinal plant species were cross-checked with 21 different studies of distinct neighboring, regional, national, and global levels for new/novel medicinal usages (Table 5). Of these, some similar reports were found for species like Bauhinia variegata for obesity [5], Cannabis sativa as a local cold drink (Tandai) against heatstroke [29], and Justicia adhatoda for throat infection [5,28,50] and cough [30]. Similarly, Ricinus communis was reported as a remedy for constipation by Matin et al. [41]; Abbasi et al. [51]; Jamal et al. [52], Salvia moorcroftiana for liver problems [28], Silybum marianum for jaundice, hepatitis, cirrhosis, Verbascum thapsus for diarrhea [5,28,41,51]^, and Vitex negundo for gas troubles [5]. Mentha longifolia was being used as a gas expeller [42], for stomach problems [53] and abdominal pain [45]. Further, Mentha royleana was mentioned for vomiting and diarrhea [29,42], and Oxalis corniculata and Polygonum plebeium for bad mouth smell and cough [5], respectively.

Ajuga integrifolia has been reported for the first time nationally for its current medicinal use (diabetes). This plant species is widely used medicinally for jaundice, as well as for hypertension [29,41]. Moreover, Ajuga integrifolia was documented for malarial fever [41], abdominal pain [51], throat sore, colic, blood purification and epilepsy [29], tonic, dental, hepatic stimulant [49]. Local community members and traditional healers of the study area used Bauhinia variegata to overcome obesity. Whereas, the literature survey suggested different uses like fuel wood [46,50], fodder, vegetable, and ornamental [46], as well as medicinal purposes, such as anthelmintic, tonic, astringent, skin diseases, ulcer, and scrofula [50]. Moreover, Bauhinia variegata was reported for gastrointestinal problems by Kichu et al. [13], as mentioned in Table 5.

Cannabis sativa has been reported for relieving from warmness and insomnia in the present study, differently from other studies, which have reported for bowels, dyspepsia, gonorrhea, tonic [28], sedative [28,41], anodyne, anti-lice [41], appetite, abdominal swelling [51], narcotic [28,31,41], anti-diarrheal, stimulant [31], and stomachache [13]. Dysphania ambrosioides has been reported by local community members for the medication of fever. Furthermore, Matin et al. [41] cited Dysphania ambrosioides for piles and stomach problems. Traditional practitioners and informants cited Cichorium intybus as effective against typhoid fever. Cichorium intybus was cited for different medicinal purposes worldwide, Qureshi et al. [28] documented it for bile secretion, digestion, stomachache, tonic, carminative, cordial, obstructed, menstrual disorder, and dropsy and Akhtar et al. [29] reported Cichorium intybus for fever. All these previously published documentations clearly specify the novelty of the current medicinal use of the plant species (Table 5).

Convolvulus arvensis is an important medicinal plant species, and in the present study, it has been cited for curing stomach problems, i.e., diarrhea and dysentery. It has also been documented for many different diseases on a national as well as global level [28,29,31,41,46]. Other plants were also reported to treat other diseases not previously reported, such as Indigofera heterantha, Malva parviflora, Mentha longifolia, and Oxalis corniculata. In the case of O. corniculata, it was used by the local inhabitants for Vitamin C deficiency and bad mouth smell; no other researcher has ever cited it for the current use in Pakistan. Whereas in the literature, Oxalis corniculata was documented for dissimilar and contradictory medicinal uses, such as anti-septic, skin curing, stomach troubles, cleaning rusted vessel [28,41], and digestion [29].

Plantago major has been mentioned in the current study for diarrhea and obesity, in which obesity was the novel use cited in the present study throughout the world. Previously, it was reported for constipation, intestinal problems [41], infected hooves [51], bedsores, and candidiasis [29]. The local inhabitants reported Polygonum plebeium for cough. After comparison, contradictory results were found, and Polygonum plebeium was reported for pneumonia and bowels with Matin et al. [41]. Several studies reported Portulaca oleracea for liver, kidney diseases [29]^, abdominal pain, diabetes, asthma [5]. Portulaca oleracea has been documented in the present study for diuretic problems. The cited medicinal use of Punica granatum in the present study is also novel throughout the world (Table 2). This very important and useful medicinal plant species was reported by many researchers for curing various infections/diseases like cough [29,31,46], dysentery [13,23,46,51], fuel wood, tonic, anthelmintic [29,46], cold, flu, nasal decongestant [31], diarrhea [13], skin diseases [23], heart palpitation, and blood pressure [5].

Ricinus communis has been reported as an important medicinal plant species in a number of studies, such as purgative, lubricant [28], bowels [29], leg sore, piles, edema [30], among other diseases. Salvia moorcroftiana has been found effective for abscesses, dysentery, and colic by Khan et al. [42] and for wound healing by Akhtar et al. [29]. Furthermore, Ahmad and Pieroni [48] cited the white juicy part of its stem as food. In the literature survey, several important diseases were found to be treated by Taraxacum officinale like Hepatitis, appetite [52], urination, kidney disorders [42], tonic [42,53], diuretic, laxative, anti-inflammatory, and digestive disorders [53]. Here, Trachyspermum amii is documented for the first time across the globe for diuretic and kidney stone removal. Abbasi et al. [51] cited it as an appetite stimulant and galactagogue. Trifolium repens is reported for curing fever, and this plant has not been used previously for the current cited problem. Khan et al. [42] reported the same plant species for worm removal (cattle poison). Many researchers cited Verbascum thapsus for various disorders like respiratory tract infection, ear infection, dry cough [52], aphrodisiac, skin problems, irritability [42].

Vitex negundo has been cited by the locals for indigestion, stomachache and gas troubles whereas other researchers reported it for variety of uncommon medicinal purposes, like for aromatic, tonic, febrifuge, diuretic, anthelmintic, headache, fuel wood [46], chest pain [23], skin problems, child crying, and snake bites [30]. Xanthium strumarium has been reported as a diuretic and for kidney stones. In the literature survey, Xanthium strumarium has been cited for skin problems [41], malarial fever [5,41], carminative [5]. Zanthoxylum armatum has been cited as a medication of abdominal pain and indigestion in the current study. The literature survey revealed Zanthoxylum armatum for different medicinal uses, such as fuel wood, digestion, aromatic, condiment, gum diseases [46], vomiting and indigestion [51], carminative, pile [23,46], malarial fever, antipyretic [29], stomachache [29], fever, and cholera [23] (see also Table 5).