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 forehead flap is usually required if the nasal defect is larger than 1.5 cm, requires replacement of support or lining, or if it is located within the infratip or columella. If the defect is small and superficial it can be resurfaced with a skin graf or it can heal by secondary intention. Limited alar defects can be resurfaced using a nasolabial flap, however, the amount of tissue available from the nasolabial area is limited and the flap is thicker, less vascular, and hair bearing in males. Nasal defects mostly result from excision of (malignant) skin tumours as basal cell carcinoma,