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WASHINGTON - At least 112 people have been killed in 24 hours of intensified clashes between Syrian regime forces and opposition groups in the  southeastern countryside of Idlib province, the U.K.-based Syrian Observatory for Human Rights (SOHR) said Friday.

The SOHR warned against an aggravated humanitarian catastrophe as Syrian regime forces and their allied militias, supported by Russian aerial power, advanced further into rebel areas and controlled at least 10 villages in Idlib’s southeast.

The watchdog group said the fighting Friday continued until the early hours Saturday as more than 460 air and ground strikes in the region killed 42 Syrian armed forces and members of allied militias, as well as 70 opposition and jihadist group fighters.

It said, since the military escalation in late April, the death toll has grown to 5,104 people, including 1,317 civilians.

Idlib province, home to about 3 million people in northwest Syria, is one the last strongholds still under control of Syrian rebels, despite  continued efforts by the Syrian government and Russia to control it. Hayat Tahrir al-Sham (HTS), a former al-Qaida affiliate, largely controls the governorate.

The United Nation’s humanitarian agency, OCHA, on Friday said an increase in airstrikes and shelling since December 16 in the Maaret al-Numan area in southern Idlib has forced thousands of civilians to flee their homes, finding shelter in urban centers farther north.

"Some IDPs [internally displaced people] have not eaten or slept for several days due to sustained airstrikes and shelling, and need urgent humanitarian support such as food assistance, shelter, non-food items such as winter clothes, and health services," OCHA said, warning that further hostilities could prevent aid organizations from reaching those in urgent need.

For years, Turkey has opposed attacks by the Syrian regime and Russian in Idlib, saying a large military operation in the province could trigger a mass exodus of Syrian civilians to Turkey.

Turkish President Recep Tayyip Erdogan Thursday warned about consequences of instability in the Idlib region.

"Now, there are 50,000 people coming to our lands from Idlib. We already host 4 million people, and now, an additional 50,000 are coming. Maybe this figure will increase even further," Turkey’s Hurriyet Daily News quoted Erdogan as saying.

Russia and Turkey in September 2018 reached a deal to reduce tensions in Idlib that required Turkey to remove all extremist groups from the province.

The forces of Syrian President Bashar al-Assad, in exchange, agreed to postpone a major planned operation in the province and other areas near the Turkish border.

But the Syrian government has resumed its offensive in Idlib in recent weeks, accusing Turkey of falling short on its part of the commitment.