At least 25 pro-government and 16 opposition fighters died in clashes south of Aleppo, where the Nusra Front and rebel militias captured a hill overlooking a major highway, a Britain-based monitoring group told The Associated Press.
The Syrian Observatory for Human Rights said fighting continued throughout the day Saturday close to the village of Tel al-Ais, which overlooks the main road connecting Aleppo with the capital, Damascus.
The coordinated rebel and Nusra Front offensive follows weeks of air raids on opposition-held areas despite a "cessation of hostilities" that came into effect late February.
But the Nusra Front is embedded with other groups throughout the country. The government has taken advantage of this ambiguity to strike and besiege opposition-held areas across Syria.
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Bombs fell near a school and a hospital in the eastern suburbs of Damascus Thursday, killing 33 civilians. Opposition officials, accusing the government, said the "massacre" threatened to derail the peace talks that are scheduled to resume in Geneva in two weeks.
Government airstrikes also targeted the public square in the opposition-held city of Maarat Nouman in the northern Idlib province Friday, where residents had protested against the Nusra Front presence in the town.
The Islam Army, whose political coordinator heads the opposition delegation during halting peace talks in Geneva, announced it had killed 20 government soldiers in fighting outside Damascus Friday.
A spokesman for a US-backed division of the Free Syrian Army accused the government of scrapping the cease-fire and undermining the Geneva talks. The group said one of its fighters was killed in the offensive against government forces in the south Aleppo countryside.