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 where initially the flap is transferred containing all tissue layers, making it an extremely safe technique. Only during the second stage, the flap - which now acts as a delayed flap - can safely be thinned aggressively according to aesthetic needs. During the final stage the pedicle is severed, the flap is thinned further and pedicle and flap are trimmed and inset. This three stage flap is especially useful for reconstructing large defects, complex contour deformations, or lining defects, while the two stage flap is used for smaller and superficial defects. Before surgery all important landmarks and reference points must