At least 51 civilians, including four children, were killed in air raids and shelling attacks in Syria’s battleground city.

At least 51 civilians, including four children, were killed in air raids and shelling attacks on Saturday in Syria’s battleground city Aleppo and the neighboring countryside, a monitoring group said.

Syrian air force raids left 15 people dead in rebel-held areas in the east of Aleppo city. Nine civilians died in rebel shelling on the government-held west, the Syrian Observatory for Human Rights said.

Another 27 people were killed in Syrian and Russian raids targeting a string of towns in the west of Aleppo province, the Britain-based group added.

Syrian doctors in opposition districts of Aleppo have accused the United States of inaction in the face of repeated atrocities in the devastated city last week.

In a heart-wrenching letter addressed to US President Barack Obama, 15 of the 35 doctors in eastern neighborhoods of Syria’s second city warned the situation would be desperate for civilians if regime forces re-impose a siege.

Rebels and allied extremists broke a three-week government encirclement that had left residents of eastern Aleppo reeling from skyrocketing prices and food shortages.

But the pediatricians, surgeons, and other physicians who signed the letter said the situation remained dire.

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