Eight civilians were killed in air and land raids on Saturday, a war monitor says, after evacuations from eastern Ghouta stalled this week. Meanwhile, eight civilians were killed and 20 others wounded in a car bomb attack in northern Al Bab city.
Regime air strikes killed at least 50 civilians in the last opposition-held town in Syria's eastern Ghouta since Friday and the regime forces launched a ground offensive on its outskirts after talks sputtered over a rebel withdrawal.
Backed by Russia, Syrian regime troops have captured nearly all of the one-time opposition stronghold of Ghouta with a combination of ferocious bombing raids and negotiated withdrawals.
The Britain-based war monitor Syrian Observatory for Human Rights (SOHR) said the bombardment of Douma killed eight people and wounded 48, including 15 children on Saturday.
On Friday, opposition activists said more than 40 people were killed in Douma.
TRT World's Abubakr al Shamahi has the latest from Afrin in northern Syria.
Ghouta's largest town of Douma is still held by the Jaish al Islam rebel faction and home to tens of thousands of people.
Moscow announced a deal with the group last Sunday, ushering in three consecutive days of evacuations from Douma that saw nearly 3,000 fighters and civilians bussed to northern Syria.
The SOHR said dozens of air strikes hit various parts of Douma, including some suspected to have been carried out by Russian warplanes.
On Douma's outskirts, the regime army entered fields surrounding the town, regime-run news agency SANA said.
Regime forces were locked in violent clashes with Jaish al Islam rebels in agricultural areas to the southwest and east of the town, the Observatory said.
'State of panic'
A medic inside Douma described to AFP chaos at the local hospital as wounded and dead were brought in.
"The hospital is in a state of panic," the medic said.
"Dentists are carrying out emergency surgeries. Dead bodies are being brought in pieces and are unrecognisable."
A doctor inside the town said state television was broadcasting the bombardment live.
"It feels like we're back in the days of the Gaza war" when Israel was bombing the Palestinian enclave and people around the world watched, he said, giving his name only as Mohammed.
Regime news agency SANA said air strikes hit the town on Friday in response to deadly rebel mortar fire from Douma.
It said mortar shells hit several suburbs of the capital and killed at four people and wounded more than a dozen.
But Jaish al Islam spokesman Hamza Bayraqdar in a statement late Friday denied that the group had targeted any Damascus neighbourhood.
The regime and its ally Russia launched a blistering air and ground offensive on eastern Ghouta in mid-February, killing more than 1,600 civilians and causing an international outcry.
The enclave on the eastern edge of Damascus had escaped regime control since 2012 and, although it had shrunk over the years, it still covered sizeable territory two months ago.
The daily air raids kept residents cowering in basements for weeks and a ground assault soon sliced the area into three isolated pockets, each held by different rebel factions.
The first two were evacuated under Russian-brokered deals last month that saw more than 46,000 rebels and civilians bussed to the northwestern province of Idlib, which the regime does not control.
Tens of thousands of people also fled through humanitarian corridors opened by Russia and Syrian troops.
Some have already returned to their devastated neighbourhoods, while others are staying in crowded shelters.
As talks over the third and final pocket of Douma dragged on, Russia and Syria's regime threatened Jaish al Islam with a renewed military assault if they did not agree to withdraw.
Those still trapped in Douma had been nervous that any attempt to renege on an evacuation would only prompt Russia and regime warplanes to resume deadly strikes.
The nature of the ongoing discussions over Douma is unclear and Jaish al Islam itself has not stated its position since this week's first evacuation.
It remains unclear exactly why the talks between Moscow and Jaish al Islam have faltered.
SANA reported that they fell apart when rebels refused to release detainees they were holding in Douma, and said Friday that "military operations against Jaish al Islam will not stop until the hostages are released."
Jaish al Islam had been angling for a reconciliation deal that would allow them to stay in Douma as a police force.
The group appears to have little leverage, however, to face the regime's recovered might, and the latest strikes raised fears of a brutal end to the five-year-old siege of eastern Ghouta.
Car bomb kills many in Al Bab
At least eight civilians were killed and 20 others injured when a car bomb exploded near a mosque in Syria's northern Al Bab city, Anadolu Agency reported.
Civil defense workers rushed to the area to help the injured and douse the fire.
Some of the injured are in critical condition, said Ammar Selmo, head of the Syrian Civil Defense in the city, fearing the death toll may rise.
No group has claimed responsibility for the attack yet.
Al Bab city was liberated from Daesh terrorist group in 2017 by the Turkish forces and Free Syrian Army during the Euphrates Shield operation.