Fan (machine) the airflow from the fans. Thus, fans may become ineffective at cooling the body if the surrounding air is near body temperature and contains high humidity. The punkah fan was used in India about 500 BCE. It was a handheld fan made from bamboo strips or other plant fibre, that could be rotated or fanned to move air. During British rule, the word came to be used by Anglo-Indians to mean a large swinging flat fan, fixed to the ceiling, and pulled by a servant, called the punkawallah. For purposes of air conditioning, the Han Dynasty craftsman and engineer Ding
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