Ceiling fan be used to reduce the stratification of warm air in a room by forcing it down to affect both occupants' sensations and thermostat readings, thereby improving climate control energy efficiency. Punkah-type ceiling fans date back to 500 BC, and are native to India. Unlike modern rotary fans, these punkah fans move air by moving to and fro, and were operated manually by cord. The first rotary ceiling fans appeared in the early 1860s and 1870s in the United States. At that time, they were not powered by any form of electric motor. Instead, a stream of running water was used,
Nasal reconstruction using a paramedian forehead flap and left to heal by secondary intention. Eyebrow malformation can occur, but is usually avoided if this method is used correctly. The two most used forehead flap techniques are the two stage and three stage forehead flap. The forehead consists of multiple layers; skin, subcutaneous tissue, frontalis muscle with fascia and a thin areolar layer. Traditionally, the forehead flap is transferred in two stages, where the flap is thinned during the first stage to improve the aesthetic result, possibly jeopardizing its vascularity and increasing chance for flap necrosis. To overcome this problem, Menick described a three stage forehead flap technique,