Objectives: ：This study aimed to explore the association between depression and perceived stress, viral anxiety, reassurance-seeking behavior, and poor sleep quality among the general population in Bangladesh, withself-efficacy as a possible mediator. Methods: ：Data on stress and anxiety during the pandemic in Bangladesh were collected through an online survey from September 16, 2021 to October 4, 2021. Viral anxiety and depression were measured using the Bangla version of Stress and Anxiety to Viral Epidemic-6 (SAVE-6) and Patient Health Questionnaire-9 (PHQ-9), re-spectively. Self-efficacy was measured by the General Self-efficacy (GSE) scale. Reassurance-seeking behavior related to the coronavirus disease 2019 infection was measured by the Coronavirus Reassurance-Seeking Behav-iors Scale (CRBS). Results: ：The CRBS showed a significant correlation with SAVE-6 (r=0.281, p<0.001) and PHQ-9 (r=0.227, p<0.001). People with higher anxiety, reassurance-seeking behavior, and poor sleep quality had lower self-effi-cacy, which led to depression. In contrast, perceived stress increased self-efficacy. The psychological factors im-pacted depression directly as well as indirectly, and self-efficacy mediated the association. Conclusions ：Viral anxiety, reassurance-seeking behavior, perceived stress, and poor sleep quality have a close correlation with depression both directly and indirectly. Self-efficacy can be a mediating factor in the asso-ciation between psychological distress and depression. Viral anxiety, reassurance-seeking behavior, and poorsleep quality reduce self-efficacy. On the other hand, perceived stress can strengthen self-efficacy.

Objectives: ：This study aimed to explore the association between depression and perceived stress, viral anxiety, reassurance-seeking behavior, and poor sleep quality among the general population in Bangladesh, withself-efficacy as a possible mediator. Methods: ：Data on stress and anxiety during the pandemic in Bangladesh were collected through an online survey from September 16, 2021 to October 4, 2021. Viral anxiety and depression were measured using the Bangla version of Stress and Anxiety to Viral Epidemic-6 (SAVE-6) and Patient Health Questionnaire-9 (PHQ-9), re-spectively. Self-efficacy was measured by the General Self-efficacy (GSE) scale. Reassurance-seeking behavior related to the coronavirus disease 2019 infection was measured by the Coronavirus Reassurance-Seeking Behav-iors Scale (CRBS). Results: ：The CRBS showed a significant correlation with SAVE-6 (r=0.281, p<0.001) and PHQ-9 (r=0.227, p<0.001). People with higher anxiety, reassurance-seeking behavior, and poor sleep quality had lower self-effi-cacy, which led to depression. In contrast, perceived stress increased self-efficacy. The psychological factors im-pacted depression directly as well as indirectly, and self-efficacy mediated the association. Conclusions ：Viral anxiety, reassurance-seeking behavior, perceived stress, and poor sleep quality have a close correlation with depression both directly and indirectly. Self-efficacy can be a mediating factor in the asso-ciation between psychological distress and depression. Viral anxiety, reassurance-seeking behavior, and poorsleep quality reduce self-efficacy. On the other hand, perceived stress can strengthen self-efficacy.

Objectives: ：This study aimed to explore the association between depression and perceived stress, viral anxiety, reassurance-seeking behavior, and poor sleep quality among the general population in Bangladesh, withself-efficacy as a possible mediator. Methods: ：Data on stress and anxiety during the pandemic in Bangladesh were collected through an online survey from September 16, 2021 to October 4, 2021. Viral anxiety and depression were measured using the Bangla version of Stress and Anxiety to Viral Epidemic-6 (SAVE-6) and Patient Health Questionnaire-9 (PHQ-9), re-spectively. Self-efficacy was measured by the General Self-efficacy (GSE) scale. Reassurance-seeking behavior related to the coronavirus disease 2019 infection was measured by the Coronavirus Reassurance-Seeking Behav-iors Scale (CRBS). Results: ：The CRBS showed a significant correlation with SAVE-6 (r=0.281, p<0.001) and PHQ-9 (r=0.227, p<0.001). People with higher anxiety, reassurance-seeking behavior, and poor sleep quality had lower self-effi-cacy, which led to depression. In contrast, perceived stress increased self-efficacy. The psychological factors im-pacted depression directly as well as indirectly, and self-efficacy mediated the association. Conclusions ：Viral anxiety, reassurance-seeking behavior, perceived stress, and poor sleep quality have a close correlation with depression both directly and indirectly. Self-efficacy can be a mediating factor in the asso-ciation between psychological distress and depression. Viral anxiety, reassurance-seeking behavior, and poorsleep quality reduce self-efficacy. On the other hand, perceived stress can strengthen self-efficacy.

Primary malignant fibrous histiocytoma (MFH) is a malignant tumor of mesenchymal origin that rarely occurs in the urinary tract, particularly in the urinary bladder. Unlike urothelial carcinoma, which accounts for most bladder cancers, it occurs in the submucosal portion of the bladder wall and consists of the lamina propria, muscularis propria, and adventitia.It is presumed to originate from poorly differentiated pluripotent mesenchymal cells in which fibroblasts and histiocytes are partially differentiated. Radiologically, it is known as the “non-papillary tumor” and is commonly diagnosed as a large mass without necrosis, which shows invasion beyond the muscularis propia. Although the prognosis of this rare malignancy depends on pathological parameters, it generally has a poor prognosis with high local tumor recurrence. Here, we present a case of primary MFH in the urinary bladder with clinical symptoms of lower abdominal pain without gross hematuria that recurred rapidly and showed an aggressive disease course.

Primary malignant fibrous histiocytoma (MFH) is a malignant tumor of mesenchymal origin that rarely occurs in the urinary tract, particularly in the urinary bladder. Unlike urothelial carcinoma, which accounts for most bladder cancers, it occurs in the submucosal portion of the bladder wall and consists of the lamina propria, muscularis propria, and adventitia.It is presumed to originate from poorly differentiated pluripotent mesenchymal cells in which fibroblasts and histiocytes are partially differentiated. Radiologically, it is known as the “non-papillary tumor” and is commonly diagnosed as a large mass without necrosis, which shows invasion beyond the muscularis propia. Although the prognosis of this rare malignancy depends on pathological parameters, it generally has a poor prognosis with high local tumor recurrence. Here, we present a case of primary MFH in the urinary bladder with clinical symptoms of lower abdominal pain without gross hematuria that recurred rapidly and showed an aggressive disease course.

Objectives: ：This study aimed to explore the association between depression and perceived stress, viral anxiety, reassurance-seeking behavior, and poor sleep quality among the general population in Bangladesh, withself-efficacy as a possible mediator. Methods: ：Data on stress and anxiety during the pandemic in Bangladesh were collected through an online survey from September 16, 2021 to October 4, 2021. Viral anxiety and depression were measured using the Bangla version of Stress and Anxiety to Viral Epidemic-6 (SAVE-6) and Patient Health Questionnaire-9 (PHQ-9), re-spectively. Self-efficacy was measured by the General Self-efficacy (GSE) scale. Reassurance-seeking behavior related to the coronavirus disease 2019 infection was measured by the Coronavirus Reassurance-Seeking Behav-iors Scale (CRBS). Results: ：The CRBS showed a significant correlation with SAVE-6 (r=0.281, p<0.001) and PHQ-9 (r=0.227, p<0.001). People with higher anxiety, reassurance-seeking behavior, and poor sleep quality had lower self-effi-cacy, which led to depression. In contrast, perceived stress increased self-efficacy. The psychological factors im-pacted depression directly as well as indirectly, and self-efficacy mediated the association. Conclusions ：Viral anxiety, reassurance-seeking behavior, perceived stress, and poor sleep quality have a close correlation with depression both directly and indirectly. Self-efficacy can be a mediating factor in the asso-ciation between psychological distress and depression. Viral anxiety, reassurance-seeking behavior, and poorsleep quality reduce self-efficacy. On the other hand, perceived stress can strengthen self-efficacy.

Primary malignant fibrous histiocytoma (MFH) is a malignant tumor of mesenchymal origin that rarely occurs in the urinary tract, particularly in the urinary bladder. Unlike urothelial carcinoma, which accounts for most bladder cancers, it occurs in the submucosal portion of the bladder wall and consists of the lamina propria, muscularis propria, and adventitia.It is presumed to originate from poorly differentiated pluripotent mesenchymal cells in which fibroblasts and histiocytes are partially differentiated. Radiologically, it is known as the “non-papillary tumor” and is commonly diagnosed as a large mass without necrosis, which shows invasion beyond the muscularis propia. Although the prognosis of this rare malignancy depends on pathological parameters, it generally has a poor prognosis with high local tumor recurrence. Here, we present a case of primary MFH in the urinary bladder with clinical symptoms of lower abdominal pain without gross hematuria that recurred rapidly and showed an aggressive disease course.