Fresh air strikes hit the Syrian rebel enclave of Eastern Ghouta on Friday, the fifth straight day of a bombing campaign that has killed more than 220 civilians.
Syrian warplanes have battered the enclave's towns since Monday, trapping thousands of families in makeshift bomb shelters and overwhelming rescue workers.
World powers failed to back an appeal by UN officials for a month-long ceasefire to allow for desperately needed aid deliveries and medical evacuations.
Bombing raids resumed on several Eastern Ghouta towns on Friday morning after a few hours of calm, AFP correspondents reported.
Residents had taken advantage of the lull to begin clearing rubble from their doorsteps and sweeping away broken glass.
In Douma, some civilians were seen scouring for salvageable items, while others rushed to the market to find food and other supplies.
But around mid-morning, an announcement blasted over mosque minarets warned of incoming strikes: "Surveillance plane in the sky. Clear the streets."
Soon after, twin strikes hit the town of Erbin, where two dozen people were killed on Thursday.
Medics in the town reported being overwhelmed by the relentless bombardment.
"From 2011 until now, there has never been the level of bombardment we've seen in the last 96 hours," said Hamza, one of doctors treating the wounded.
The Syrian Observatory for Human Rights said at least 75 people died on Thursday, three of wounds suffered the previous day.
That brought the civilian death toll since Monday to nearly 230.
Eastern Ghouta is home to an estimated 400,000 people who have lived under crippling government siege since 2013.
More than 4,000 families live in basements and bunkers for fear of air strikes, according to Save the Children.
"The siege means there is nowhere for them to escape. There must be an immediate halt to the fighting and an end to the siege," said Save the Children's Syria response director, Sonia Khush.
(This story has not been edited by Business Standard staff and is auto-generated from a syndicated feed.)