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Severe tetanus requires intensive care with sedatives and muscle relaxants

It upregulates the expression of anti-inflammatory genes, including NF-BIA , MAP3K8 , and TLR5 , while concurrently downregulating pro-inflammatory genes such as TNFSF6 , TNF- , and nuclear factor-B ( NF-B ) [36,37,38,39]

However, recent clinical and experimental data suggest that there are discrepancies between studies indicating that HE is likely to be a heterogenous entity