Throughout the world, traditional medical systems heavily rely on medicinal plants. [1].From the beginning of this century, more focus has been placed on studies of medicinal plants and how widely they are used worldwide. [2-4]. The field of ethnomedical research has enormous potential and scope for the creation of novel medications. Numerous novel medications have been developed from conventional medications [5].Numerous studies suggest that in order to advance local healthcare and preserve medical knowledge for future generations and innovative drug development, it is imperative that it be reported [6].According to [4]. traditional knowledge of medicinal plants is crucial for preserving biological variety and cultural practices The ethnomedical knowledge of a society is influenced by various variables, including religious practices [7].Ramadan fasting is one of these religious practices. One of the five main pillars of Islam, Ramadan fasting is required of all healthy adult Muslims. [8].Muslims fast from sunrise to sunset during the month of Ramadan, refraining from eating and drinking in accordance with Islamic law. This means that Ramadan is linked to important adjustments in food, physical activity, and sleeping patterns [9]. For example, in Saudi Arabia It was shown that during the month of Ramadan, one-third of Saudi families considerably decreased their physical activity [10].indicating that Muslim societies may be adopted particular physiotherapeutic practices [7] In Saudi Arabia, few previous reports exist ethnomedicinal plants and their traditional practices. Therapeutic plants usage for treatment in traditional medicine in Makkah are documented in the literature [11,12]. However, there is a lack of published data regarding the traditional customs and ethnomedicinal plants used during the holy month of Ramadan in Makkah. Here and for the first time, ethnomedicinal plants and their traditional practices for therapies during holy month of Ramadan in Makkah, Saudi Arabia are explored. A promising approach to finding efficient remedies and preventive for diseases that contemporary medicine is unable to cure is an ethnomedical examination of medicinal recipes used during Ramadan. [7,13], particularly those associated with contemporary lifestyles like diabetes, obesity, and colonic illnesses. Furthermore, a useful method for the preservation and enhancement of plant biodiversity and its valuation is the documentation of traditional knowledge via scientific ethnopharmacological research [14]

Study area Four fifths of the Peninsula are contained inside the 2,250,000 square kilometre Kingdom of Saudi Arabia (KSA) [15]. The city of Makkah is the subject of this study (Figure 1). Makkah, the capital of the Makkah province, is situated in Saudi Arabia's western region, coordinates are 21°26′N and 39°46′E. In a valley situated on the Red Sea coast, roughly 80 km from Jeddah, within the subtropical dry zone [16]   Makkah is the most culturally diversified city in the Islamic world [11]. Every year, millions of Muslims from over 180 nations go to Makkah for the Hajj, one of the world's largest religious gatherings [17] Research on the floristic composition and vegetation of Makkah revealed that the Pinaceae (with 31 species) and Fabaceae (with 24 species) are the two most dominant families. The research area's most common species are those found in typical dry subtropical ecosystems. The floristic elements of Makkah are Sudano-Zambezian (16.22%), Irano-Turanian (17.91%), and Saharo-Arabian (27.70%). Medicinal plants account for the majority of plant applications in Makkah (24.57%), with grazing plants coming in second (23.88%; [19] Figure 1. Saudi Arabian map with the research area highlighted [11]   Data collection and interviews Ethnobotanical fieldwork took place over four weeks in Makkah from March to April 2024 and during the month of Ramadan. To record traditional knowledge, individual free-listing and semi-structured interviews were conducted during the month of Ramadan [19,20]. The field study on ethnobotany was conducted while paying close regard to ethical regulations. According to the Code of Ethics of the [21,22] ethical standards. Each participant gave written or verbal informed consent prior to the questionnaire and interviews.  In total, 75 adults were interviewed, all of them are local (born in Makkah province), ages ranging between 20 and 75 years old (Table 1). Interviews were conducted in Arabic.  The selection of informants who utilize medicinal herbs was done using targeted sampling [23]. During interviews, focus was put on documenting local names, local uses, plant used, administration and preparation, toxicity and adverse effects of employed plants, and plant mixes. Plant names were given in Arabic. According to [24] qualitative data were helpful in understanding people's attitudes, beliefs, and goals as well as in interpreting quantitative data.   Table 1 Code Gender Age Marital status Literacy Number of children Source knowledge Number of plants listed inf1 Men 20-25 Married Primary education (Arabic) 1 Neighbors 1 inf2 Women 20-25 Single Undergraduate (Arabic) 0 Mother 1 inf3 Women 46-50 Married Undergraduate (Arabic) 3 Television 1 inf4 Women 26-30 Married Undergraduate (Arabic) 2 Grandparents 1 inf5 Women 56-60 Divorced Primary education (Arabic) 6 Mother 2 inf6 Women 46-50 Married Secondary education (Arabic) 4 Grandparents 1 inf7 Women 56-60 Married Primary education (Arabic) 8 Grandparents 2 inf8 Men 51-55 Married Secondary education (Arabic) 1 Television 1 inf9 Women 36-40 Married Secondary education (Arabic) 4 Internet 2 inf10 Women 41-45 Married Secondary education (Arabic) 4 Internet 2 inf11 Women 36-40 Married Secondary education (Arabic) 4 Internet 1 inf12 Women 31-35 Married Secondary education (Arabic) 2 Mother 1 inf13 Women Older than 75 Married Illiterate (Arabic) 11 Neighbor’s 1 inf14 Women 51-55 Married Primary education (Arabic) 4 Grandparents 1 inf15 Women 46-50 Married Secondary education (Arabic) 6 Personal experiences 1 inf16 Women 20-25 Single Undergraduate (Arabic) 0 Mother 2 inf17 Women 46-50 Married Undergraduate (Arabic) 3 Mother 1 inf18 Women 20-25 Single Secondary education (Arabic) 0 Mother 1 inf19 Women 41-45 Married Undergraduate (Arabic) 5 Mother 2 inf20 Women 51-55 Married Secondary education (Arabic) 7 Grandparents 1 inf21 Women 41-45 Married Undergraduate (Arabic) 6 Mother 5 inf22 Women 41-45 Married Undergraduate (Arabic) 6 Grandparents 4 inf23 Women 20-25 Single Secondary education (Arabic) 0 Grandparents 1 inf24 Women 51-55 Married Undergraduate (Arabic) 5 Mother 2 inf25 Men 36-40 Single Secondary education (Arabic) 0 Television 1 inf26 Women 20-25 Single Undergraduate (Arabic) 0 Internet 2 inf27 Men 26-30 Married Undergraduate (Arabic) 0 Mother 1 inf28 Women 26-30 Married Undergraduate (Arabic) 0 Doctor 1 inf29 Women 31-35 Married Postgraduate (Arabic) 2 scientific lectures 4 inf30 Women 36-40 Married Undergraduate (Arabic) 3 School 1 inf31 Women 46-50 Married Undergraduate (Arabic) 4 Mother 2 inf32 Women 41-45 Married Undergraduate (Arabic) 2 Neighbor’s 1 inf33 Women 31-35 Married Undergraduate (Arabic) 2 Mother 1 inf34 Women 20-25 Single Undergraduate (Arabic) 0 Neighbor’s 1 inf35 Women 20-25 Single Undergraduate (Arabic) 0 Grandparents 1 inf36 Women 51-55 Married Primary education (Arabic) 4 Mother 1 inf37 Women 51-55 Married Illiterate (Arabic) 10 Mother 1 inf38 Women 41-45 Married Primary education (Arabic) 2 Mother 2 inf39 Women 20-25 Single Undergraduate (Arabic) 0 Internet 1 inf40 Men 56-60 Married Secondary education (Arabic) 2 Mother 1 inf41 Women 61-65 Married Primary education (Arabic) 10 Mother 1 inf42 Women 41-45 Married Undergraduate (Arabic) 4 Mother 2 inf43 Women 36-40 Married Secondary education (Arabic) 4 Mother 2 inf44 Women 41-45 Married Secondary education (Arabic) 4 Mother 1 inf45 Women 31-35 Married Undergraduate (Arabic) 1 Mother 1 inf46 Women 41-45 Married Secondary education (Arabic) 4 Internet 1 inf47 Women 36-40 Married Secondary education (Arabic) 4 Internet 1 inf48 Women 51-55 Divorced Undergraduate (Arabic) 5 Mother 2 inf49 Women 56-60 Widowed Secondary education (Arabic) 6 Mother 1 inf50 Women 41-45 Married Undergraduate (Arabic) 4 Mother 1 inf51 Women 36-40 Married Undergraduate (Arabic) 3 Mother 1 inf52 Women 41-45 Married Postgraduate (Arabic) 4 Mother 2 inf53 Women 31-35 Married Undergraduate (Arabic) 3 Grandparents 1 inf54 Women 41-45 Married Undergraduate (Arabic) 2 Mother 2 inf55 Men 20-25 Single Undergraduate (Arabic) 0 Grandparents 1 inf56 Women 20-25 Single Secondary education (Arabic) 0 Mother 1 inf57 Men 26-30 Single Secondary education (Arabic) 0 Internet 1 inf58 Women 36-40 Married Undergraduate (Arabic) 2 Television 1 inf59 Women 51-55 Married Primary education (Arabic) 8 Grandparents 1 inf60 Women 41-45 Married Secondary education (Arabic) 2 Grandparents 1 inf61 Women 36-40 Married Undergraduate (Arabic) 5 Mother 1 inf62 Women 20-25 Married Undergraduate (Arabic) 3 Mother 1 inf63 Men 51-55 Married Undergraduate (Arabic) 2 School 1 inf64 Women 20-25 Single Undergraduate (Arabic) 0 Mother 1 inf65 Women 36-40 Married Undergraduate (Arabic) 3 Mother 1 inf66 Women 20-25 Single Undergraduate (Arabic) 0 Mother 1 inf67 Women 36-40 Married Undergraduate (Arabic) 3 Grandparents 5 inf68 Women 41-45 Married Secondary education (Arabic) 7 Grandparents 4 inf69 Women 31-35 Single Undergraduate (Arabic) 0 Grandparents 1 inf70 Women 26-30 Single Undergraduate (Arabic) 0 Internet 1 inf71 Women 31-35 Single Undergraduate (Arabic) 0 Grandparents 1 inf72 Women 51-55 Married Primary education (Arabic) 5 Mother 1 inf73 Women 36-40 Married Secondary education (Arabic) 3 Mother 1 inf74 Men 41-45 Divorced Primary education (Arabic) 0 Grandparents 2 inf75 Men 56-60 Married Secondary education (Arabic) 6 Grandparents 1     Plant collection and identification The majority of voucher specimens came straight from informants. In situations where this was not feasible, they were purchased from nearby stores and supermarkets. Mounted plant specimens were placed in the herbarium of Umm Al-Qura University. Plant identification was carried out in the herbarium of Umm Al-Qura University using specimens of herbarium, the Flora of KSA [25] and Flora of KSA [15]. The author confirmed the identification. Families and nomenclature adhere to the 2015 Catalogue of Life.   Data analysis The gathered data were entered into Excel as "use reports" (UR).  One informant's citation of a plant's use, including its common name, component used, local use, preparation, and administration, is called a "use report." Utilizations were categorized based on disease categories using the International Classification of Primary Care. The information from the database was summarized using descriptive statistics.

Medicinal plants consumed during holy month of Ramadan Out of 111 use reports, a total of 41 colloquial names for medicinal plants were recorded, belonging to 41 different medicinal plants (23 families; Table 2). Forty-one medicinal plants were identified at species level. Plant uses were documented for 14 therapeutic categories. The most diverse families were Apiaceae (20%; 8 species) and Lamiaceae (15%; 6 species) Amaranthaceae, Asteracea, Fabaceae, Lauraceae, Malvaceae and Zingiberaceae were represented by 2 species each (5%). Fifteen families were represented by only one species (Figure 2). The most popular species consumed during holy month of Ramadan were (Mentha spicata L. and Pimpinella anisum L.), which have the highest frequency, followed by (Zingiber officinale Roscoe) and (Cinnamomum cassia (L.) Presl; Thymus vulgaris L.). New citation of medicinal plants is represented by Corchorus olitorius L. Plant parts that were most frequently employed were the leaves (39%), seeds (22%) and roots (15%). Fruits (10%), flowers (5%), bark (2%), resin (2%), peel (2%) and blub (2%; Figure 3). Table 2 Comprehensive inventory of the plants consumed during holy month of Ramadan including the scientific name, vernacular name(s), family, part(s) used, preparation, administration therapeutic use categories, frequency of citation and voucher specimen. voucher specimen Frequency ofcitation Therapeutic use categories Administration Preparation part used Vernacular name Family Scientific name   MPR 1 1 Skin Place it directly Infusion Roots Khawajua عشبة خوا جوا Boraginaceae Alkanna tinctoria (L.) Tausch 1 MPR 2 2 Pressure, Immune Oral ingestion (food) No preparation Blub Thum ثوم Amaryllidaceae Allium sativum L. 2 MPR 3 1 Skin Place it directly Take out the gel Leaves Sabbar صبار Asphodelaceae Aloe vera (L.) Burm.f. 3 MPR 4 1 Digestive Oral ingestion (drink) Mix with water Leaves Krfs كرفس Apiaceae Apium graveolens L. 4 MPR 5 1 Immune Oral ingestion (drink, food) Powder, mix with honey Roots Qasdhindi قسط الهندي Asteraceae AucklandiacostusFalc. 5 MPR 6 2 Hair, Blood Oral ingestion (drink) Mix with orange juice Roots Banjr الشمندر Amaranthaceae Beta vulgaris L. 6 MPR 7 2 Digestive Oral ingestion (drink) Decoction, infusion Leaves Shay akhdar شاهي الاخضر Theaceae Camellia sinensis (L.) Kuntze 7 MPR 8 6 Diabetes, Digestive, Period Oral ingestion (drink) Decoction, infusion Bark Qurfa قرفة Lauraceae Cinnamomum cassia (L.) Presl 8 MPR 9 1 Blood Oral ingestion (drink) Mix with food Leaves Waraqalghar ورق الغار Lauraceae Cinnamomum tamala(Buch.-Ham.) Th. G. G. Nees 9 MPR 10 4 Digestive, Immune Oral ingestion (drink, food) Decoction, mix with food Fruits Limon ليمون Rutaceae Citrus limon (L.) Burm. fil. 10 MPR 11 2 Immune Oral ingestion (drink) Decoction Peels Qashralbun قشر Rubiaceae Coffea arabica L. 11 MPR 12 1 Digestive Oral ingestion (drink) Decoction Resin Myrr مُر Burseraceae Commiphoramyrrha (Nees) Engl. 12 MPR 13 2 Digestive Oral ingestion (food) Mix with food Leaves Malukhia ملوخية Malvaceae Corchorus olitorius L. 13 MPR 14 1 Diabetes Oral ingestion (drink) Decoction Leaves Kozbra كزبره Apiaceae Coriandrum sativum L. 14 MPR 15 1 Digestive Oral ingestion (food) Mix with food Fruits Khiar خيار Cucurbitaceae Cucumis sativus L. 15 MPR 16 4 Digestive Oral ingestion (drink, food) Decoction, mix with food Seeds Kamun كمون Apiaceae Cuminum cyminum L. 16 MPR 17 4 Digestive, Diabetes, Skin, Blood Oral ingestion (drink, food) Decoction, infusion، mix with food Roots Karrakum كركم Zingiberaceae Curcuma longa L. 17 MPR 18 3 Blood, Eye Oral ingestion (drink, food) Juice, mix with food Roots Juzur جزر Apiaceae Daucus carota L. 18 MPR 19 2 Digestive Oral ingestion (drink) Decoction, infusion Seeds Shamr شمر Apiaceae Foeniculum vulgare Mill. 19 MPR 20 4 Pressure, Digestive Oral ingestion (drink) Infusion Flowers Karakadi كركديه Malvaceae Hibiscus sabdariffa L. 20 MPR 21 1 Digestive Oral ingestion (drink) Decoction Seeds Shaeir شعير Poaceae Hordeum vulgare L. 21 MPR 22 3 Hair,Digestive- General and unspecified Oral ingestion (drink, food) Decoction, infusion، mix with food Seeds Kitan كتان Linaceae Linum usitatissimumL. 22 MPR 23 5 Digestive Oral ingestion (drink) Decoction, infusion Flowers Babunj بابونج Asteraceae Matricaria chamomilla L. 23 MPR 24 8 Digestive Oral ingestion (drink) Decoction, infusion Leaves Nena نعناع Lamiaceae Mentha spicata L. 24 MPR 25 2 Digestive Oral ingestion (drink) Decoction Leaves Rihaan ريحان Lamiaceae OcimumbasilicumL. 25 MPR 26 1 Digestive Oral ingestion (drink, food) Mix with food Fruits Zeetoun زيتون Oleaceae Olea europaea L. 26 MPR 27 1 Digestive Oral ingestion (drink) Decoction Leaves Bardaqush بردقوش Lamiaceae Origanum syriacumL. 27 MPR 28 1 Urological Oral ingestion (drink) Decoction Leaves Baqdunas بقدونس Apiaceae Petroselinum crispum (Mill.) Fuss 28 MPR 29 8 Digestive, Respiratory, Period Oral ingestion (drink) Infusion Seeds Yansun يانسون Apiaceae Pimpinella anisum L. 29 MPR 30 2 Diabetes Oral ingestion (drink) Decoction Leaves Maryamia ميرميه Lamiaceae Salvia officinalis L. 30 MPR 31 3 Digestive Oral ingestion (drink, food) Decoction, mix with food Leaves Aklelaljabal اكليل الجبل Lamiaceae Salvia rosmarinusSchleid. 31 MPR 32 2 Digestive Oral ingestion (drink) Decoction Leaves Sana maki سنا مكي Fabaceae Senna alexandrina Mill. 32 MPR 33 1 Endocrine Oral ingestion (drink) Mix with milk Seeds Sesamum سمسم Pedaliaceae Sesamum indicum L. 33 MPR 34 1 Hair, Skin Oral ingestion (food) Mix with food Leaves Sbankh سبانخ Amaranthaceae Spinacia oleracea L. 34 MPR 35 6 Immune, Digestive, Respiratory Oral ingestion (drink, food) Infusion, mix with food Leaves zatar زعتر Lamiaceae Thymus vulgaris L. 35 MPR 36 1 Digestive Oral ingestion (drink) Decoction Seeds Nankha نانخة Apiaceae Trachyspermumammi (L.) Sprague 36 MPR 37 3 Digestive Oral ingestion (drink) Infusion Seeds Helba حلبة Fabaceae Trigonella foenum-graecum L. 37 MPR 38 1 Digestive Oral ingestion (food) Mix with food Seeds Chia شيا Sapotaceae Vitellaria paradoxaC.F.Gaertn. 38 MPR 39 1 Blood Oral ingestion (drink) Infusion Fruits Zabib زبيب Vitaceae Vitis vinifera L. 39 MPR 40 7 Digestive Oral ingestion (drink) Decoction, infusion Roots Zanajabil زنجبيل Zingiberaceae Zingiber officinale Roscoe 40 MPR 41 1 Hair Place it directly Mix with water Leaves Sader سدر Rhamnaceae Ziziphus spina-christi (L.) Desf. 41 Figure 2 The most plant families consumed during holy month of Ramadan. Figure 3 The most plant parts consumed during holy month of Ramadan.  

Here and for the first time, ethnomedicinal plants and their traditional practices for therapies during holy month of Ramadan in Makkah, Saudi Arabia were explored. Due to the customs and cultural heritage of the community, particularly during the holy month of Ramadan, the majority of people pursue traditional rituals. The people of Makkah are primarily connected to folklore medicine. Apiaceae and Lamiaceae have a high number of plant citations during holy Ramadan in Makkah and in different parts of KSA [11,26,27] as well as around the world [28.29]. Ethnomedically, many plants of these families are used as home-based treatments for treating different diseases. Such families have a variety of phytochemicals and secondary metabolites which are potential drug source [26] Plants from these families exhibit therapeutic qualities, and traditional medicine has made extensive use of them especially Cuminum cyminum and Foeniculum vulgare from Apiaceae [30] and Mentha spicata from Lamiaceae [31],which are present in the flora of KSA. Although, Zingiberaceae is not native in the flora of KSA, it is one of the most commonly cited families. This is in agreement with observations in Makkah [11] The most popular species consumed during holy month of Ramadan are (Mentha spicata L. and Pimpinella anisum L.), which have the highest frequency. They are said to be nourishing and advantageous for gastrointestinal issues and the body's detoxification process. Zingiber officinalen L. was assigned the third most consumed during holy month of Ramadan. Known for its therapeutic qualities in conventional medicine, it is widely utilized throughout the world [29,32,33] to help treat a variety of illnesses, including pain, constipation, indigestion, nausea, vomiting, asthma, coughing, inflammation, and loss of appetite [34] New citation of medicinal plants is represented by Corchorus olitorius L. as it was not previously mentioned in Makkah [11,12] or even throughout Saudi Arabia [27,35] All plant parts were used to treat different diseases. The most plant parts used in the present study are leaves (39%) and seeds (22%), this corresponds with the studies carried out by [33,36,11,37] There have been prior reports from Saudi Arabia regarding the prevalence of leaves in traditional medicine. [11,26] and in other part in the world Morocco [38] Turkey [13,39] Based on prior ethnobotanical research, leaves are among the plant components most frequently employed in ethnomedicinal surveys conducted in the Indian Himalayas to prepare medicines [40] The preference for leaves may be because as the principal component of plants, they are the source of photosynthesis. In addition, it is easy to collect and use leaves [41,36] Additionally, they contain a lot of essential oils and secondary metabolites that have therapeutic value [42].While gathering roots or entire plants can pose a serious threat to the local flora, leaves have no negative influence on the survival of medicinal plants [37] The preference for seeds, this could be due to some plant seeds have the potential to be a source of useful medicines and to improve the health status of their consumers as a result of the existence of different compounds essential to good health [43]. According to [44] flavonoids, which are abundant in most seeds, are regarded to have health-promoting qualities because of their strong antioxidant activity and capacity to scavenge free radicals. Thus, they are important for human health [45] Less used plant material is bark. reported that fewer hard components of plants, including bark, were utilized.   Limitations This study, while pioneering in documenting ethnomedicinal practices during Ramadan in Makkah, faces several limitations. First, the sample size of 75 participants, although adequate for initial exploration, may not capture the full diversity of ethnomedicinal knowledge across different demographics and neighborhoods in Makkah. The reliance on purposive sampling might have introduced selection bias, limiting the generalizability of the findings to other regions in Saudi Arabia or the broader Muslim community. Additionally, the study focused only on the traditional knowledge of plant use during one Ramadan season, making it susceptible to seasonal variations that may influence plant availability and usage patterns. Another limitation lies in the potential for inaccuracies in plant identification due to local dialects or linguistic variations in plant names, despite verification through herbarium specimens. Furthermore, the study primarily relied on qualitative interviews, which could be influenced by participant recall bias or cultural sensitivities that may affect the willingness to share information. Finally, while the study provides a descriptive overview of the therapeutic applications of medicinal plants, it did not conduct pharmacological assessments to confirm their efficacy, limiting the scientific validation of traditional claims. Future studies should aim for larger, more representative samples, year-round documentation, and integration of laboratory-based analyses to provide a more comprehensive understanding of ethnomedicinal practices during Ramadan.

This investigation listed the medicinal herbs that were ingested in Makkah during the holy month of Ramadan. This investigation identified 41 species that are utilized to treat 14 therapeutic categories and are spread throughout 23 botanical families. New citation of Corchorus olitorius L. was documented. In Saudi Arabia, the month of Ramadan is distinguished by a wealth of medicinal plants legacy and concordant knowledge among informants, which is mostly derived from traditional intangible cultural heritage and popular practices. In conclusion, to preserve the ethnobotanical intangible heritage of Saudi Arabia, documentation efforts are urgent to avoid the extinction of this ethnobotanical heritage. Future research on potential synergies between the medical properties of medicinal plants and the health advantages of fasting is recommended   Acknowledgements The author expresses gratitude to the graduation project group, Irtiwaakhusayfan, Shatha Al-Nashiri, Bushra Alsulami, Shahad Al-Asmari, RahmaAlthagafi ,Shouq Al Otaibi and Layal Al Zahrani for their assistance in data collection.   Data availability statement: All data is available in the manuscript.

The authors declare no conflict of interest.  

None.