Selepas terbukti Dr Syihabuddin bin Mohd (Din Kapak Abdullah) membohong, beliau mencabar saya hari demi hari untuk menjawab beberapa persoalan. Ini adalah taktik to divert attention away from his embarrassment of being exposed as a pathological liar.
The questions are reproduced below. The screenshot on the right is Syihabuddin trying to prove (deceive) that he did not lie when he said “Masalah penyerapan ivermectin ke paru-paru, Caly sendiri mencadangkan 2 uM sebagai kepekatan berkesan di paru-paru…” i.e. he was criticising Caly for recommending an unsafe dosage but he was easily caught out again. Beliau tunjuk hanya sekerat apa yang Caly menyatakan. Rujuk blog post Dr Syihabuddin’s failed attempt at proving his lie was not a lie.
Part A
Brader, tq bagi komen sini. Lu banyak membohong la brader, pastu lu cakap gua membohong. Sekarang ni pulak lu putar belit perbualan tu, dan lu tak jawab pun soalan utama dia brader.Ini kita belum masuk bab human trial @ clinical trial brader. Dah tentu gua nak tahu ulasan lu pasal clinical trial ivermectin ni brader, kenapa lu senyap?
Dr Syihabuddin mendakwa saya membohong tetapi tidak bagi tahu pula apa yang saya membohong dan apa buktinya. Perbualan yang Syihabuddin maksudkan adalah interview beliau bersama Prof Madya Mohd Makmor dan Prof Madya Ernieda. Rujuk Facebook post MENJAWAB DR SYIHABUDDIN BERKENAAN INTERVIEW BERSAMA PENSYARAH-PENSYARAH FARMASI. Saya telah mencabar beliau mengeluarkan full written transcript of his interviews but he has flatly refused because he knows the transcript will make him appear like a clown in a talk show.
Berkenaan human/clinical trial, sila rujuk perenggan bertajuk “Studies on ivermectin” di bawah.
1. Soalan utama Prof Mohd Makmor, berapa target concentration ivermectin in human untuk antiviral covid action? Lu ada jawapan? Bawak sini sekali dengan rujukan.
Syihabuddin bertanya soalan yang Prof Madya Mohd Makmor dan Prof Madya Ernieda sendiri tidak tahu jawapannya. Hakikatnya tiada siapa yang tahu what the result would be with cell culture in a petri dish or test tube that would reflect the effective oral dosage for humans because the conditions in vitro and in vivo are too different. Then why is Syihabuddin asking me?
Basically, Syihabuddin is challenging me to give the target concentration because he is embarrassed and angry that his claim that the target concentration was 32x the normal dose was dismissed as rubbish. Syihabuddin marah bila orang kata kesimpulan beliau perlu 32x ganda dos biasa adalah karut so dia mencabar saya bagi target concentration yang betul.
I can’t offer a precise value (and nobody can at this time) tetapi yang pasti, target concentration will be much lower than 2µM dan tidak perlu 32x ganda dos biasa untuk ivermectin berkesan sebagaimana didakwa oleh Syihabuddin. Rujuk balik ulasan saya di blog post Ivermectin: Menjawab kekeliruan Dr Syihabuddin (KKM) kali ke-2:
That notwithstanding, as indicated in many in vivo studies and observational studies, the effective dosage (taken orally) is likely to be in the region of 200 µg/kg – 400 µg/kg for humans (and it could also safely be higher). This may translate to an average of about one or two 12mg pills per week (or perhaps every 3 days for frontliners) for prophylaxis and about the same once/twice a day for 5-7 days for treatment if infected with covid-19. This is merely indicative. If infected with covid-19, it depends on how early/late the treatment, the weight of the person, the severity of symptoms and if there are comorbidities. The doctor who is well versed in ivermectin will know better what to administer to his patient, which may also include vitamins, zinc, doxycycline or even aspirin for that matter. The problem is, however, the government has banned doctors from treating covid patients with ivermectin despite it being a safe and effective drug.
Namun Syihabuddin hebat telah menentukan dos berkesan untuk manusia adalah 272 biji ivermectin berdasarkan kajian setengah masak beliau sendiri. Beliau menyatakan sedemikian semasa perbualan talipon beliau bersama Prof Madya Ernieda.
Since clinical and observational studies have been based on 200 µg/kg – 400 µg/kg thereabouts for humans and Syihabuddin believes it is easy to deduce therefrom the target concentration in vitro (in vero cells, Calu-3 or lung aveolar cells and whatever other cell culture he chooses) then Syihabuddin should come up with his own simulation model for this. The medical fraternity will also be anxiously waiting for Syihabuddin to publish his paper on his 272 tablets claim and his study design. It might even make him rich.
2. Lu langsi sangat tuduh gua bohong pasal study, study mana ntah gua bohong tu. Yang cadang IC50 2 uM to Caly sendiri, lu baca habis tak paper Caly tu brader? Lu ada belajar rasa malu tak brader?
Syihabuddin marah saya menuduh beliau membohong dan buat-buat tak tahu saya telah membuktikan beliau membohong. Sila baca posting berikut: KKM’s Dr Syihabuddin’s failed attempt at proving his lie was not a lie. Sebenarnya, yang tidak habis baca paper Caly dan tidak rasa malu dengan kesilapan dan pembohongan sendiri adalah Syihabuddin.
Semua orang yang baca paper Caly dengan teliti akan tahu dos yang digunakan oleh Caly adalah pada sel Vero/hSLAM (monkey kidney cells) tetapi, untuk memburukkan ivermectin dan Caly, Syihabuddin membohong dengan mendakwa “Masalah penyerapan ivermectin ke paru-paru, Caly sendiri mencadangkan 2 uM sebagai kepekatan berkesan di paru-paru” walaupun Caly tidak mengatakan demikian. Juga sangat jelas Caly mencadangkan “the current approved dosage” untuk manusia dan bukannya 32x ganda dos biasa (i.e. cadangan karut Syihabuddin), bermaksud kepekatan 2µM tersebut tidak relevan untuk manusia.
Sudah terang lagi bersuluh Caly suggested the current approved dosage (i.e. not 32x the approved dosage) despite recognising that high dose ivermectin has comparable safety as the standard low-dose treatment.
And yet Syihabuddin persists with his lie by now repeating “Yang cadang IC50 2 uM to Caly sendiri” out of context, whereas the meaning of “the current approved dosage” is clear. Nak jelas macam mana lagi dos apa yang Caly mencadangkan? Namun sehinggi kini Syihabuddin masih menyalahkan Caly kononnya mencadangkan dos tahap toksik untuk manusia.
Saya telah membalas komen Syihabuddin tersebut di Section III – Ivermectin: Menjawab kekeliruan Dr Syihabuddin (KKM) kali ke-2. Obviously Syihabuddin is a pathological liar.
3. Isu utama, dos yang Caly pakai tu, walau apa pun tujuan dia buat eksperimen tu, dos itu tak dapat dicapai dalam manusia. Lu pun tak bangkang kan gua punya pengiraan? Takde kan? Lu sembang² lebat ni takde pun lu kata pengiraan gua tu salah kan?
(i) “dos itu tak dapat dicapai dalam manusia”
Berkenaan tujuan eksperimen, telah lama dijawab:
“the study by Caly et al merely indicated that ivermectin was found to have anti-SARS-CoV-2 activity in vitro — no more, no less.” — Asiya Kamber Zaidi & Puya Dehgani-Mobaraki
Syihabuddin is repeating himself due to his confused state of mind although I had already explained the concentration issue in my previous blog post:
(ii) “takde pun lu kata pengiraan gua tu salah kan”
Berkenaan pengiraan Syihabuddin saya juga telah pun menjawab maka saya hairan kenapa Syihabuddin masih bertanya berkenaan pengiraan beliau yang karut yang wajar ditongsampahkan:
4. Maka kembali ke square one, at what dose in human ivermectin ni boleh bunuh virus Covid? Lu paham tak soalan ni brader?
Saya faham soalan tetapi masalahnya Syihabuddin tidak faham jawapan. Sila rujuk balik jawapan kepada soalan 1 di atas. Yang pasti, jawapannya bukan cadangan bodoh 32x kali ganda dos biasa. Syihabuddin juga masih keliru berkenaan mechanism of ivermectin, whereby the primary role of ivermectin is to inhibit the virus from dockling with the cell and from replicating, bukannya membunuh virus. The immune system will then respond to destroy the virus, which is why relatively low concentration may be sufficient for ivermectin to do its job.
Ini telah diterangkan dengan jelas kepada Syihabuddin – rujuk blog post Menjawab Dr Syihabuddin berkenaan dos ivermectin. Kalau Syihabuddin masih tidak faham, it is due to his own incompetence.
5. Sebab itu gua cakap, seelok ya Caly ni tak guna 1 dos je, paling kurang guna 2 dos. Dia dah tahu highest concentration in human 0.28 uM, standard mana² lab test untuk drug yang dah tahu highest concentration or Cmax or perhaps LD50, maka gunalah dos lebih rendah, kalau dia guna dos lebih rendah dan ivermectin berjaya bunuh virus dalam ujian makmal, takde orang nak bising pun dgn eksperimen dia tu brader. Kenapa lu susah sangat nak faham bab ni brader?
Syihabuddin samada tidak membaca habis penulisan saya atau tidak faham atau Syihabuddin mudah lupa. Syihabuddin is still confused about the purpose of Caly’s experiment (which was with monkey kidney cells, the only choice of cell culture at that time in Jan/Feb 2020, rather than the more ideal lung alveolar cells), which was NOT to figure out the therapeutic dosage for humans but to observe whether ivermectin had any antiviral activity and did inhibit the virus. Rujuk balik Section III – Ivermectin: Menjawab kekeliruan Dr Syihabuddin (KKM) kali ke-2. Saya tak tahu kenapa susah sangat Syihabuddin nak faham bab tersebut.
6. Prof Ernieda bukan setakat setuju dgn 32 kali ganda tu, even dia cakap ex supervisor PhD dia cakap 500 kali ganda lebih tinggi. Dr Steven Lim principle investigator i tech trial KKM cakap 50 to 100 times higher. Gua ni kira rendah dah gua bagi 32 tu. Sebab gua compare 5 uM dgn highest dose human ever took. Depa compare dgn normal doses and perhaps lower yang dapat banyak tu.
Air liur sahaja tidak ada nilai. Tunjuk kepada kami semua kertas kajian yang membuktikan perlu dos 500x ganda untuk ivermectin berkesan. Banyak kajian yang menunjukkan ivermectin berkesan dengan dos biasa Syihabuddin tak nak percaya but just one phone call with someone who said that someone else said that 500x normal dose is the effective dose, Syihabuddin terima bulat-bulat. What was the study design? What cell culture was used? What were the limitations of the study mentioned?
Tiada masalah, tunjuk sahaja kertas kajian sesiapa — Prof Madya Ernieda ke, ex supervisor PhD ke, Dr Steven Lim ke, Prof Mohd Makmor ke, Dr Harith Kamal ke, Dr Luqman Alhakim ke, tukang kebun Syihabuddin ke, derebar lori sampah ke — yang membuktikan 50x, 100x atau 500x ganda dos biasa adalah perlu untuk ivermectin berkesan. Until then, these are just unsubstantiated claims from Syihabuddin.
So lu paham tak ni brader? Yang nampak desperate ni lu, bukan gua. Dan lu masih tak menjawab banyak soalan. Gua takde kerja nak layan karenah lu nak pergi buat transcript tu semua, lu dengar la sendiri. Manimalar pun boleh dengar 2 kali, lu dengar la berapa kali lu nak. Nak jumpa pakar 2 org tu pun gua boleh tolong arrange, tapi lu jangan kecut la.
Tidak jelas kenapa Syihabuddin kata saya nampak desperate. Yang menembak banyak komen dan soalan (dan copy & paste merata komen dan soalan2 yang sama) adalah Syihabuddin. Yang membohong apa yang Caly kata adalah Syihabuddin. Yang marah dengan semua orang yang tidak bersetuju dengannya adalah Syihabuddin. Yang menyampuk dan buat kecoh bila Dr Manimalar bertanya soalan kepada Prof Madya Mohd Makmor adalah Syihabuddin. Yang mintak nyawa dengan Prof Madya Mohd Makmor dan Prof Madya Ernieda adalah Syihabuddin. Yang selalu mencabar saya menjawab ini itu adalah Syihabuddin. Namun Syihabuddin kata saya pula yang nampak desperate. Syihabuddin juga mendakwa saya tidak menjawab banyak soalan walaupun saya telah banyak menjawab dengan memberi ulasan saintifik dan rujukan. Syihabuddin falsely accuses me of what he himself is guilty of, which is indeed the nature of a pathological liar.
Terbukti Syihabuddin takut megeluarkan full written transcript telephone coversation beliau bersama Dr Mohd Makmor dan Dr Ernieda. Syihabuddin tahu sekiranya dibuat transcript tersebut, orangramai akan nampak in black & white perbualan tersebut tiada yang membuktikan fakta dan ulasan saintifik dalam penulisan saya adalah salah. Even worse, the full written transcript would also show the lack of quality of the interview and Syihabuddin’s pitiful attempts to get his interviewees to endorse his views. Therefore, my take on the interview as written in my Facebook post stands as correct.
Sekali lagi saya mencabar Syihabuddin beranikan diri untuk buat full written transcript of both telephone conversations supaya orangramai boleh menilai. Ataupun Syihabuddin takut orang akan ketawa?
Tiada sebab untuk saya menyahut cabaran Syihabuddin untuk berjumpa mereka berdua but if they insist on meeting me physically face-to-face then I’ll be happy to oblige and the venue shall be at my office in PJ or Shah Alam. I’ll have many questions for them to answer and you can be sure the meeting will be recorded and a full written transcript will be produced and published. I’ll leave it for Syihabuddin to arrange the meeting.
Lastly, apa pendapat lu pasal human trial on ivermectin ni? Lu tanak cakap pape ke? Manimalar up until now tak dapat jawab soalan gua, mungkin lu boleh tolong jawab.
1. Give me one clinical trial that is low risk of bias, enough sample size with good quality that can prove ivermectin is really effective in Covid. 1 je gua mintak. So kalau ada boleh gua roger KKM utk consideration masukkan ivermectin dalam protocol rawatan. 1 je cukup la, kalau ada banyak lagi okay.
This demonstrates Syihabuddin’s low mentality and deficiency in critical thinking. He has set his own conditions for the kind of studies or clinical trials that is acceptable to him. Syihabuddin is happy with only ONE such clinical trial that meets his conditions. In addition to his past rambling, empty rhetoric and immature remarks, Syihabuddin’s demand with pre-conditions further indicates that he is …. how can I put this politely…. an idiot.
Syihabuddin doesn’t know evidence when it slaps him in the face.
Studies on ivermectin
“All clinical trials suffer from risks of bias in their design and conduct, as assessed by the Cochrane Risk of Bias 2.0 tool that assesses trial biases with the grades of “some concern, low, moderate, high, or serious”. Although one group of authors has assessed many of the trials as having moderate to severe risks of bias, performing meta-analyses of these trials can more accurately detect the true effects despite individual trial biases. Multiple groups, including ours, have performed meta-analyses of these trials, with all groups finding CONSISTENT BENEFITS amongst the trials. In fact, the CONSISTENCY of trial results from both sets of randomized and observational controlled trials from varied centers and countries and trial sizes and disease phases LEND EVEN MORE VALIDITY to the estimates of benefit.” – FLCCC Alliance
Recall what I had said previously on the subject of clinical trials, in vivo studies and observational studies and the like:
Berkenaan kajian2 in vivo pula, sebagaimana yang saya beberapa kali kata, golongan taksub WHO/vaksin akan mencari salah dan kelemahan tiap2 kajian ivermectin dengan pelbagai alasan. Saya ulang apa yang saya kata: Doktor2 KKM dan pentaksub mereka akan dakwa kajian2 tersebut tak ikut Cochrane standard, tak cukup bilangan pesakit dalam kajian, ada plagiarism, falsified data, takde RCT, kajian cacat, kajian ditarik balik etc etc. That is their standard rhetoric. Responses have been given on the removal of the Elgazzar study by Research Square (without first clarifying with the authors). 40 doctors/scientists also responded to the biased systematic review by a group, published by Oxford University Press on behalf of CDC. The fault-finding attacks won’t stop.
Syihabuddin is too narrow-minded and blinkered to be able to understand the totality of evidence. He only sees things in black or white. It’s 100% or zero. He cherry-picks stones while ignoring the mountain. Ini adalah pendekatan dan cara pemikiran yang sempit dan bodoh.
“We did the work that the medical authorities failed to do, we conducted the most comprehensive review of the available data on ivermectin. We applied the gold standard to qualify the data reviewed before concluding that ivermectin can end this pandemic.” – Dr Pierre Kory
“Our latest research shows, once again, that when the totality of the evidence is examined, there is no doubt that ivermectin is highly effective as a safe prophylaxis and treatment for COVID-19. We can no longer rely on many of the larger health authorities to make an honest examination of the medical and scientific evidence. So, we are calling on regional public health authorities and medical professionals around the world to demand that ivermectin be included in their standard of care right away so we can end this pandemic once and for all” – Dr Paul E. Marik, M.D., FCCM, FCCP, founding member of the FLCCC and Chief, Pulmonary and Critical Care Medicine at Eastern Virginia Medical School
Syihabuddin ignores the many studies that favour ivermectin. In summary:
“There is evidence of a negative publication bias, and the probability that an ineffective treatment generated results as positive as the 64 studies is estimated to be 1 in 222 billion.”
ivmeta.com
Rujuk juga: Summary of the Evidence for Ivermectin in COVID-19
Hanya mereka yang hati dan akal sudah buta are unable to recognise and rationalise all of the above studies.
It’s time for Syihabuddin to stop beating around the bush. Syihabuddin mendakwa ivermectin tidak berkesan dengan pembohongan dan percakapan yang putar belit. Saya mencabar Syihabuddin to state the estimated probability that ivermectin is an ineffective treatment. Whether the probability is 100%, 95% or 80%, it should be supported with rational explanations. I am not even demanding for any statistical or mathematical computation i.e. I do not need to see formulas and numerical workings. Rational explanations would suffice sebab tujuan saya mencabar beliau adalah untuk orangramai menilai based on logic and common sense. Let’s see if Syihabuddin tries to convince us with logic or confuse us with nonsense.
Soalan theory yang manimalar tak jawab:-
A. Manimalar claim ivermectin dalam paru2 manusia dibantu oleh immune system, so apa ivermectin-immune mechanism ni? Boleh story?
B. Apa marker immune tu? What cell lineage or marker?
C. Study apa untuk support those theory?
Kalau lu tak boleh faham bab dosing tu pun, at least lu tolong la manimalar jawab soalan tu, kesian dia gua tengok, dah macam makcik² pasar membebel. Lu jangan stress², lu chill² sudah. Tq
Syihabuddin masih bertanya berkenaan mechanism of ivermectin. Refer to my previous posting: Menjawab Dr Syihabuddin berkenaan dos ivermectin. There are also pictures in the post for Syihabuddin to easily understand the theory of how ivermectin works at many levels. For details, refer to the following article: The mechanisms of action of Ivermectin against SARS-CoV-2: An evidence-based clinical review article (Asiya Kamber Zaidi & Puya Dehgani-Mobaraki).
It’s incredible that Syihabuddin believes that the natural immune system will do nothing. Habis kalau bukan sistem imun yang bertindakbalas untuk melawan/membunuh virus, apa lagi? Jinn? Syihabuddin should sometimes just apply a little bit of common sense instead of demanding scientific proof for everything.
Regarding ivermectin working with the immune system, I had also previously shared the following simple explanation by Dr Kylie Wagstaff & David Jans.
It’s puzzling why Syihabuddin still does not understand that ivermectin works with the immune system. Then again, it’s not the first time he has demonstrated poor level of comprehension.
Part B
Ya, ada lagi lagi Syihabuddin mencabar saya menjawab. Tak habis-habis. Seperti saya pernah bertanya, saya doktor ke dia doktor? Syihabuddin talks and asks questions more than he listens. Saya rasa beliau ni manusia yang bermasaalah.
Soalan 1: Rujuk balik jawapan di perenggan bertajuk “Studies on ivermectin” di atas (Part A).
Soalan 2: Berkenaan artikel tersebut tidak di peer review, ini perkara kecil. More importantly, the two funders of the study were in a position of a conflict of interest — one was involved in vaccine development and the other also funded studies on mRNA vaccines. Meaning, these parties would not want to see a favourable report for ivermectin because if ivermectin was effective for prophylaxis and therapeutic treatment, FDA’s emergency use authorisations (EUA) for COVID-19 vaccines would no longer be required and vaccine hesitancy would increase. It’s that simple.
Nonetheless, those considerations aside, I still went ahead to explain why Kumar’s in vitro results would not represent the reality based on scientific facts and rationale. Rujuk balik blog post Menjawab kekeliruan Dr Syihabuddin berkenaan kajian in vitro Kumar (Netherlands).
Soalan 3: Rujuk balik jawapan di Part A – soalan 3 di atas. Juga rujuk perenggan bertajuk “refute VD Schmitz calculation” di blog post Ivermectin: Menjawab kekeliruan Dr Syihabuddin (KKM) kali ke-2.
Soalan 4: Sudah berapa kali telah diterangkan kepada Syihabuddin bahawa IC50=2µM tersebut tidak relevan untuk manusia. It was merely an observation for monkey kidney cells. Caly tidak mencadangkan apa-apa dos yang akan berkesan untuk manusia sebagaimana 32x ganda dos biasa yang ditentukan oleh Syihabuddin. Caly cuma membuat kesimpulan ivermectin boleh menghalang ivermectin dari menjangkiti sel and prevent the virus from replicating. Caly kemudian mencadangkan the current approved dose untuk human trials — baru kemudian boleh agak kalau berkesan dengan dos biasa (ataupun lebih tinggi dari FDA-approved dose asalkan tidak memudaratkan). Rujuk balik juga jawapan di Part A – soalan 1 di atas.
Syihabuddin telah beberapa kali menyebut “1MDB” tanpa penjelasan lanjut.Saya tidak pasti kenapa dan tidak tahu apa yang perlu dijawab berkenaan 1MDB. Mungkin beliau cuba memberi gambaran hujah berkaitan 1MDB tidak sama dengan hujah berkaitan ivermectin. What else can I say other than that I agree, even if it is a meaningless and worthless comparison. Syihabuddin should just focus on ivermectin instead of throwing in unrelated issues into the mix, which merely makes him appear emotional and irrational.
Penutup
Notice the manner that Syihabuddin’s asks questions. Observe his tone and language. HIs questions have no other purpose than to avoid losing an argument. He will lie, divert and twist the meaning of statements to deceive his audience. Someone left this comment at this blog a few days ago, which just about sums it up about Syihhabuddin:
Others also describe Syihabuddin in similar fashion on Facebook. I hope Syihabuddin can be more mature and intellectual in discussions so that the public can understand and appreciate true facts versus misinformation, instead of being distracted by rhetoric, unnecessary technical jargon, irrelevant issues and half-baked questions.
– AA –
Azmi Arshad 