BEIRUT -- At least 21 civilians were killed in a wave of artillery fire in east Aleppo on Wednesday morning that struck a neighbourhood crowded with people displaced from other parts of the city.

It was the second time the Jub al-Quba neighbourhood, in the rebel-held eastern side of the city, was struck in as many days. An airstrike blamed by activists on the government killed 25 civilians Tuesday.

Meanwhile, eight civilians, including two children, were killed in shelling on the government-held western side of the city, according to state media. The government blamed rebels for the attack.

Many of the victims in Jub al-Quba died in the streets, with their belongings packed in bags by their sides, photos showed. Jawad al-Rifai, who took the pictures for the Aleppo Media Center, said they were civilians -- mostly women and children -- fleeing shelling and air strikes on other parts of the city.

The neighbourhood and others around it in Aleppo's centrally-located old city have absorbed thousands of residents displaced by the advance of government troops in the east.

Abdulkafi Alhamdo, a teacher living in the Zabadieh neighbourhood in eastern Aleppo, said refugees were filling up apartment buildings long abandoned because of the war.

"They are every now and then knocking on my door asking for simple things, like spoons, cups, plates, some salt," as well as medicine, he told reporters using a messaging service.

The Britain-based Syrian Observatory for Human Rights, which monitors the war in Syria through a network of local contacts, said tens more were wounded in Jub al-Quba.

Observatory chief Rami Abdurrahman said he predicts death tolls will spiral in east Aleppo as the internal displacement creates more residential density.

The Syrian Civil Defence search-and-rescue group operating in eastern Aleppo, also known as the White Helmets, put the toll at 45 killed. It blamed the government for the strikes.

Rescue efforts by the group were hampered by the lack of functioning machinery, said Rifai.

"Most of their equipment is out of service because of the targeting against their quarters," he added.

Tens of thousands of people have been displaced in Aleppo as pro-government Syrian forces press on with their campaign to reclaim the divided city.

The Observatory said more than 50,000 out of an estimated quarter-million inhabitants have been displaced by attacks on rebel-held eastern Aleppo over the past 4 days. Many of them fled to safer ground in areas under government or Kurdish control. The International Committee of the Red Cross says around 20,000 people have fled.

The Lebanese Al-Manar TV channel, operated by Hezbollah, reported from the Aleppo countryside that pro-government forces were advancing in the southern portion of the city's rebel enclave. The government has seized much of the northern half of the enclave in a swift advance that began Saturday.

Syrian state media announced midday Wednesday that its forces had retaken the southern Sheikh Saeed neighbourhood, while the Observatory said rebels still held onto a third of the area. The Observatory added that Iraqi militia fighters were playing a central role in the government's advance from the south.