More casualties are feared buried under the rubble of buildings in Aleppo
At least 14 patients and three doctors have been killed in an air strike on a hospital in the Syrian city of Aleppo, the charity Medecins sans Frontieres (MSF) says.
Among those killed in the MSF-supported al-Quds hospital was one of the city's last paediatricians, MSF said.Local sources have blamed the Syrian government or Russian war planes, but there has been no official comment.
Monitors say attacks by both sides left 34 dead and dozens wounded on Thursday.
Violence in Syria has intensified in recent days, despite a partial truce.
The upsurge in violence comes amid reports that the Syrian army, backed by Russian air power, is gearing up for a major offensive in Aleppo.
The escalation has threatened to derail the UN-brokered peace talks, which resumed last month.
On Wednesday, the UN envoy to Syria urged the US and Russia to intervene "at the highest level" to save the talks.
The air strikes threaten to sink the Geneva peace talks
It said that the hospital was well known locally and had been hit by a direct air strike on Wednesday.
"We condemn the destruction of the al-Quds hospital, depriving people of essential healthcare," the charity added.
An activist at the scene, named as Zuhair, told the BBC that buildings around the hospital were also hit.
"It was an air strike by two rockets, heavy rockets from [a] Russian air strike," he said.
"Near the hospital one building on five floors just crumbled and just crashed down and we don't know how many dead will be under these ruins."
He said that over the past 48 hours an average of one Syrian had been killed every 25 minutes and one wounded every 13 minutes.
For the peace talks in Geneva to succeed, he added, hostilities would need to be reduced to the levels immediately following the February agreement.
Calling on the US and Russia to co-operate, Mr de Mistura said the legacies of both President Barack Obama and President Vladimir Putin were linked to the success of the peace process in Syria.
More than 270,000 people have been killed since Syria's bitter civil war conflict erupted in 2011 and millions have been forced to flee.
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