Previous studies have also shown that lowering IL-6 and TNF-α is linked to improved hemodynamic stability and reduced secondary infection risk in severe poisoning, which may partly explain the more favorable clinical trajectory in the HP group.18 It is possible that this effect is mediated by pralidoxime, which binds phosphorylated acetylcholinesterase, restoring its activity in hydrolyzing acetylcholine and reducing the accumulation of acetylcholine in the body.9,16,17. This evidence concerns the gene TNF and infection.