Research article University of Swabi Journal (USJ); Open access

Ethnomedicinal Assessment of Snake Bite Treatment in District Bannu, KPK-Pakistan

Wasim Ahmad*1, Mushtaq Ahmad1, Nadia Latif2, Rahmat Ali Khan1

1
Department of Biotechnology, University of Science & Technology, Bannu KPK-Pakistan

2
Department of Botany, University of Science & Technology, Bannu KPK-Pakistan

Abstract

Snake bite poisoning is a matter of great trepidation around the globe, particularly in developing
countries. Every year, approximately 5 million cases of snake bite are reported resulting in 125,000 deaths
worldwide. The morbidity and mortality remains un-documented in most of the rural parts as the victims
are first attended by the traditional healers. Pharmacological investigations explored the use of numerous
parts of the medicinal plants for antagonizing the effects of venom and purified toxins. Herbs are more
common in use than shrubs and trees. The various parts used as an anti-dot against snake bite
envenomation are as: leaves >roots > whole plant > flower > wood > fruit > milky juice. The current
study revealed, for the first time, the use of various medicinal plants against snake bite envenomation in
district Bannu and its peripheries. Though, pharmacological and chemical investigations are imperative to
make confirmation of anti-venom claims about these medicinal Pakistani plants.

Key words: Snake envenomation, Ethnomedicinal, Medicinal plants, Traditional healers

*Corresponding author address: Wasim Ahmad

Department of Biotechnology, University of Science & Technology, Bannu KPK-Pakistan

Contact:+92928664061

Email: vazim4847@[Link]

Uni. J. Swabi., Vol.1, Issue, 1. November 2017, pp. 33-40

Research article University of Swabi Journal (USJ); Open access

1. Introduction

Many hot and sub humid regions of the world are facing snakebites envenomation which has become
an important health problem for a common man. In pastoral areas, the cases of snakebites remain
unreported and due to this very reason, epidemiological data is difficult to be [Link] estimation
shows the victims/year asmore as five million resulting about 125,000 deaths worldwide[1]. All the
developed and undeveloped countries are facing the hazards of snakebites [Link] some rustic
areas, snakebite is animportant cause of indisposition and death among adults and children. Many
domestic animals are killed by snakes including puff adders (Bitisarietans) etc. Snakebites mayresults in
many serious infestations [2]. Even though,snakebite is lethal,no significant efforts were made to cope
with this problem by developing anti-dots, both at National and International levels [3].In 1894,
Calmettedeveloped the treatment with anti-sera which is still under consideration by the medical
community.

Snake venom, which is actually its modified saliva, is a complex mixture of chemicals and enzymes
and it is of neurotoxic or haemotoxic in nature [4]. There are many limitations of the snake venom anti-
sera including high fi price, unapproachability for the residents of rural areas, stowage environments, and
proper dosage & handling techniques etc [5]. Another shortcomingis the inappropriate protection against
snake venom induced cell necrosis, kidney failure and hemorrhage.

Medicinal plants are known to possess pharmacologically active compounds with known inhibitory
effects against snake bite envenomation. Plant’s use against snake venom got attention of the researchers
in recent years. Studies from different parts of the world explored the neutralization reaction of plants
against snake envenomation[6,7]. In developing countries, 80% of the snake bite victims approaches to
the traditional healers before consulting the health care professionals [8](WHO report, 2010).

District Bannu, KPK-Pakistan was formed by the British Empire in 1861. Its total area is 1.227 km2
(474 sq ml) with population about 1,073,000 in 2014. The Bannu district is positioned in the heart of the
southern region, adjoining the districts of Karak in East-North, Lakki Marwat in East-South and the North
and South Waziristan agencies (Fig 1).The traditional practioners of the area uses medicinal plants to
combat snake bite envenomation but the use of these plant had never been reported systematically yet.
This mini review documents, for the first time, the use of medicinal plants against snake bite
envenomation in Bannu. In this review, 10 medicinal plants are enlisted which are used against snake
envenomation in this area.

Uni. J. Swabi., Vol.1, Issue, 1. November 2017, pp. 33-40

Research article University of Swabi Journal (USJ); Open access

2. Data Collection

Traditional healers of various peripheries of district Bannu (Kakki, Ghoriwala, Mamash Khel,
KuramGarhi, BakkaKhel, Havaid, Nizam Bazar) were visited and data was collected (December 2016 to
June 2017)and compiled for systemic record. Literature was also reviewed to match and compare the
obtained data with previously reported medicinal plants. Various physicians of District Head Quarter
Teaching Hospital and KGN Teaching Hospital Bannu were also visited to get back their opinion
regarding victim’s attendance to them. Most of them confirmed that the guardians/relatives of patient
approaches first to their nearby traditional practioner and then reported to hospital.

3. Medicinal plants used in District Bannu against snakebite envenomation

10 different plant species were explored to be used against snakebite envenomation. Moreover, use of
different parts of the plant was also investigated and recorded. The table 1 shows these some of
thesemedicinal plants and their usage, according to the opinion of the various local traditional practioners.
Some of the plants mentioned in this study are also reported in reports of other researchers but mood of
preparation and administration may differ. Fig 2 and 3 shows different plant parts used against snake bite
envenomation and life forms of medicinal plants. All these plants are distributed throughout the Pakistan.
Literature showed the use of all parts of the plants against snakebite. Leaves contained 35% anti-venom
activity, roots 25%, whole plant 21%, flower 7%, fruit 5%, wood (Bark )5% and milky lattice 2% (Fig 2).
Similarly, plants are used in numerous life forms including herbs 55%, Shrubs 31% and trees 21% (Fig
3). The current proportion indicates that the herbs play more significant role against snake bite
envenomation as compared to shrubs and trees.

Medicinal plants comprise numerous bioactive composites which are known to inhibit and neutralize
the action of snake venom [9].These composites might be triterpenes, phenylpropanoid products,
polyphenols, curcuminoids, coumarins, flavonoids, acids and polysaccharides etc. their isolation is
already done and effects against snakebite envenomation are reported (Table 2). It is noted that a single
compound do not accounts for the anti-snake venom activity rather all the existing compounds act
interdependently to reflect the potential of a plant.

Recently, the author explored the promising inhibition of krait snake venom acetylcholinesterase by
methanolic extract of a medicinal plant [10]. Many other important plants are still to be explored and
researcher’s attention is to be needed in order to isolate some of the compounds which might be helpful in
the development of newer drugs against snake bite envenomation. Literature review showed that a no of
medicinal plants which are grown and cultivated in Pakistan, are not scientifically screened for their anti-
venom potential. Medicinal plants are supposed to be a neutralizing agent against venom of the poisonous

Uni. J. Swabi., Vol.1, Issue, 1. November 2017, pp. 33-40

Research article University of Swabi Journal (USJ); Open access

snakes and causes to release the venom from the receptors site. The receptors then free for action with
acetylcholine and as a result, normal respiration starts back. The neutralized venom is then expelled from
the body [Link] plant’s active compounds might play a key role in neutralizing the circulating
venom. Many plants are reported whose active compounds are identified and isolated. Many plants
mixtures are used as nasal inhaler to recover the snake bite victim from the coma. This mini review also
explored the use of a medicated stone by some of the traditional healers against snake envenomation. The
stone is directly applied on the injury site. According to their statement, the stone stick itself t the site and
absorb the venom. It falls automatically after absorbing all the venom. For detoxification, the stone is
dipped in milk. It is then dried and used. The author donot agree with the belief and perceptions of these
healers regarding use of the medicated stone as it don’t have any scientific logic.

Figure 1: Map of District Bannu

Uni. J. Swabi., Vol.1, Issue, 1. November 2017, pp. 33-40

Research article University of Swabi Journal (USJ); Open access

Fruit, 5 Milky Juice, 2

Wood, 5

Flower, 7

Leaves, 35

Whole plant,
21

Roots, 25

% usage of plant's parts

Figure 2: Plant’s parts which are under consideration against snake’s bite envenomation

Forms of Medicinal plants used

14
31

Tree
55 Herbs
Shrubs

Figure 3: Parts of a plant that are used to treat snake’s bite

Uni. J. Swabi., Vol.1, Issue, 1. November 2017, pp. 33-40

Research article University of Swabi Journal (USJ); Open access

Table 1: List of some medicinal plants and their parts used aginst snake’s bite poisoning

Plant Specie Family Occurrence Parts used

Albizia lebbeck (L.) Benth Mimosaceae Many parts including: All parts
Karachi, Punjab, Kutch,
Indus dalta

Ageratum houstonianum Mill Compositae Attock, Bannu , Kohat Leaves and

inflorescence
juice

Cassia occidentalis Linn Caesalpinaceae (M-2) Lahore-Islamabad Roots only

Motorway,
Rawalpindiand
Baluchistan

Leucas capitata Desf Labiatae National Park Islamabad, Whole plant

Rawalpindi, Swat,
Poonch, Dir, Chitral and
Lower Hazara

Uni. J. Swabi., Vol.1, Issue, 1. November 2017, pp. 33-40

Research article University of Swabi Journal (USJ); Open access

Oxalis corniculata Linn Oxalidaceae Shady places in Sind, Leaves

KPK, Chitral, Hunza &
Hazara

Salvadora persica Salvadoraceae All over the Pakistan Leaves and

flowers

Vicia sativa L. Papilionaceae Rawalpindi, Kallar Whole plant

Kahar, Hasan Abdal,
Abbottabad

4. References
1. Chippaux JP. Snake-bites, Appraisal of global situation. Bulletin of the World Health
Organization.(1998),76, 515-524.
2. Kini RM. Excited ahead: structure, function and mechanism of snake venom phospholipases A2
enzymes. Toxicon, (2003), 42, 827–840.
3. Ahmad SS, Husain SZ. Ethno medicinal survey of plants from Salt Range (Kallar Kahar) of
Pakistan. Pakistan Journal of Botany. (2008), 40, 1005–1011.
4. Das K. Medicinal plants for snake bite treatment- future focus. Ethnobotanical Leaflets.(2009),
13, 508-521.
5. Alam MI, Gomes A. Viper venom-induced inflammation and inhibition of free radical formation
by pure compound (2-hydroxy-4-methoxy benzoic acid) isolated and purified from anantamul
(Hemidesmus indicus R. BR) root extract. Toxicon. (1998), 36, 207–215.
6. Blaylock RS. The treatment of snake bite in Zimbabwe Cent. African Journal of Medicine.(1982),
28237-264.
7. Kunjam SR, Jadhav SK, Tiwari KL. Traditional herbal medicines for the treatment of snake bite
and scorpion sting by the tribes of South Surguja, Chhattisgarh, India. Medicinal and Aromatic
Plants. (2013), 2, 120-123.
8. WHO; Snake envenomation, (2010). Fact sheet No 337, Available from
[Link] factsheets/fs337/en/

Uni. J. Swabi., Vol.1, Issue, 1. November 2017, pp. 33-40

Research article University of Swabi Journal (USJ); Open access

9. Wasim A, Mushtaq A, Rauf A, Sania F, Zakir K, Zia UH. Phytochemistry and cytotoxicity of
Prosopis spicigera using Brine Shrimp Lethality assay. Top Class Journal of Herbal Medicine.
(2014), 3, 14-16.
10. Wasim A, Mushtaq A, Rahmat AK, Nadia L. Promising inhibition of krait snake’s venom
acetylcholinesterase by Salix nigra and its role as anticancer, antioxidant agent. Indian Journal of
Animal Research. (2016), 50, 317-23.

Uni. J. Swabi., Vol.1, Issue, 1. November 2017, pp. 33-40