Further, such cultural, ethnic, or tribal values are not often condemned by the major religious and political leaders in developing Muslim countries or in immigrant communities in the West. On the contrary, such communities maintain an enforced silence on all matters of religious, cultural, or communal "sensitivity." Today, such leaders (and their many followers) often tempt, shame, or force Muslim girls and women into wearing a variety of body coverings including the hijab (head covering), burqa , or chadari (full-body covering) as an expression of religiosity and cultural pride or as an expression of symbolic resistance to the non-Muslim West.  Muslim men are allowed to dress like Westerners, and no one challenges the ubiquitous use of Western technology, including airplanes, cell phones, the Internet, or satellite television as un-Islamic. But Muslim women are expected to bear the burden of upholding these ancient and allegedly religious customs of gender apartheid.
Figure 1 29 shows a suggested diagnostic algorithm to determine if a patient has IDA. This algorithm is adapted from a clinical guideline, with the primary modification that serum iron, total iron-binding capacity, and transferrin saturation are recommended as follow-up tests in patients with an intermediate ferritin level as a strategy to reduce the need for bone marrow biopsy. 29 If these blood tests are indeterminate, an elevated serum transferrin receptor level is recommended to distinguish IDA from anemia of chronic disease. The choice of a ferritin level of less than 45 ng per mL (45 mcg per L) is to allow for a higher sensitivity, despite the fact that most laboratories' normal range for ferritin includes 45 ng per mL.