A suicide bomber driving an ambulance has killed four people in an unprecedented attack on a hospital that took Syria's civil war to President Bashar al-Assad's ancestral hometown for the first time, according to a monitoring group.

Saturday's attack in Qardaha was reported as the Syrian Observatory for Human Rights said government troops had executed 48 people earlier this week in a northern village, among them 10 children.

"A man drove an ambulance packed with explosives into the parking lot of the Qardaha hospital. Another man was in the vehicle with him, but it was unclear whether he was an accomplice or a hostage. Four people were killed in the attack," Rami Abdel Rahman, head of the Syrian Observatory, said.

Earlier, state television had reported the blast but did not specify the nature of the attack.

The attack, the first explosion to hit the heart of the western town since the outbreak of Syria's civil war in 2011, killed a nurse, a hospital employee and two soldiers, Abdel Rahman said.

The outskirts of Qardaha have previously come under rocket fire, while Latakia province - where the town is located - has seen several rounds of heavy fighting.

A mausoleum containing the graves of Assad's father and predecessor, Hafez, and brother Bassel, is located in Qardaha.

The family has ruled Syria for more than 40 years.

Reports of executions

Separately, the Syrian Observatory said 10 children and 13 rebels were among 48 people executed by government forces in the northern village of Rityan earlier this week.

The killings took place after troops entered the town on Tuesday, during an offensive aimed at cutting rebel supply lines to the Turkish border.

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Abdel Rahman said all the dead were from six families.

"There was no resistance except in one house where a rebel opened fire at troops before being executed along with his family," he said.

The brief seizure of Rityan was part of an abortive army offensive this week to encircle the rebel-held east of Aleppo and relieve two besieged Shia villages to its north.

By Friday all but one of the villages taken by government forces had been recaptured by the rebels, who include fighters from al-Qaeda affiliate Nusra Front.

The heavy fighting claimed the lives of 129 loyalists and 116 rebels, including a Nusra Front commander, according to a Syrian Observatory count.

While the ground offensive failed, fighter jets kept pounding rebel areas of Aleppo city and other parts of the country.

Aleppo city deaths

On Saturday, two women and two children were among eight people killed when a barrel bomb hit a building in an opposition-held area of Aleppo city, once Syria's commercial capital.

Six people were also reported killed in rebel shelling of government-held areas of Aleppo.

The air force also killed at least 10 people in rebel areas east of Damascus on Saturday, the Syrian Observatory said.

According to the group, they were the latest of more than 7,000 people killed across Syria since the UN Security Council passed a resolution last year ordering an end to sieges and indiscriminate use of weapons in populated areas.

The Syrian Observatory "has documented the killing of 5,812 civilians, including 1,733 children, 969 women and 3,110 men in barrel bombings and [other] air raids" over the past year.

In the same period, rebel fire on government-held areas killed 1,102 people, the Syrian Observatory said, adding that 234 of them were children.

And 313 people died in areas under army siege in the past year, as a result of food and medical shortages, despite the fact that the resolution also ordered the lifting of sieges.

Source: AFP