Syria's Aleppo city was the scene of mass carnage on Wednesday with at least 81 civilians killed in air strikes on rebel-held neighbourhoods, a local rescue group said.
First responders said the divided city's eastern sector was pounded by more than 50 Russian and Syrian government missile attacks throughout the day that also wounded more than 87 people - some in critical condition.
"Up until this moment the Civil Defence is still working to pull people from the rubble," Ibrahim Abu Leith, an Aleppo-based spokesman for the rescue group also known as the White Helmets, told Al Jazeera.
Earlier in the day, air strikes on a busy marketplace in the Fardous neighbourhood killed at least 22 people.
Dr Farida, a gynaecologist whose clinic was in the market, said it was not clear what the aircraft were targeting.
"Many stores totally disappeared. I can't find a trace of a mini-market I used to buy things from," she told the Associated Press news agency, asking that her last name not be published because of security concerns.
"The destruction is horrible," she said. "The rubble has piled up and the roads are cut."
According to Abu Leith, 45 people were killed in Fardous alone.
"We only have three doctors in our hospital and about eight nurses. We couldn't accept all the injured at the same time," Modar Sheikho, an emergency nurse in Fardous, told Al Jazeera.
According to global charity Doctors Without Borders, there are only 11 ambulances left for the 275,000 people who remain in the rebel-held sector. Only 35 doctors are still there.
Pro-government forces have opened at least seven different fronts across the divided city.
"Last week the Syrian army said it would reduce its air strikes to allow people in rebel-held east Aleppo to leave. There were a few days of calm, but there was no corridor for civilians to evacuate to other rebel-held areas," Al Jazeera's Zeina Khodr said, reporting from Gaziantep along the Turkey-Syria border.
And while there has been "criticism" from the international community, said Khodr, there has been "little action…food supplies are running low and medical services are overwhelmed".
OPINION: When will Iran abandon Bashar al-Assad?
The latest strikes have shattered a relative lull in the area, where hospitals, underground shelters, and buildings had been targeted for weeks.
The surge in attacks on Wednesday came as Russia announced it would hold new peace talks with the US and regional powers this weekend.
Source: Al Jazeera News