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Fighting between Syria's rebels and loyalist troops raged in two Damascus neighbourhoods on Tuesday while shelling of a village near the capital left four members of a family dead, a watchdog said.
"Fierce battles broke out in the Barzeh district of northern Damascus. Shelling in the area wounded five people and caused material damage," said the Syrian Observatory for Human Rights, which relies on a broad network of activists, doctors and lawyers for its reporting.
"Clashes also raged in the outskirts of Jobar (in eastern Damascus), next to Abbasiyeen square," the monitoring group added, referring to one of the capital's main squares.
Violence has escalated in Damascus in recent weeks as the army battles to push back insurgents seeking to penetrate the capital from enclaves in the outskirts.
Shelling on Al-Hajar Al-Aswad in southern Damascus killed at least three men and wounded more than 20 civilians, the Observatory said.
In Mqailyabeh in Damascus province, large swathes of which are under insurgent control, army shelling killed a three-year-old boy, his five-year-old sister, their mother and grandmother, the group added.
Tuesday's violence comes a day after at least 150 people were killed, among them 69 civilians, 44 rebels and 37 loyalist troops, the Observatory said.
The month of March was the deadliest in Syria's two-year conflict, with more than 6,000 people killed, the watchdog said.
The UN says more than 70,000 people have been killed since March 2011, when a protest movement broke out against President Bashar al-Assad.
The peaceful movement spiralled into an insurgency after the army unleashed a brutal crackdown on dissent.