BEIRUT: ISIS fighters Tuesday killed over 40 people, mostly civilians, in an attack on a central Syrian village, opposition activists and Syrian state TV said.

The assault on the government-held village of Mabuja was the latest atrocity by the Sunni extremist group, which last week released a video showing its militants beheading eight men said to be Shiites from the central province of Hama.

The group launched an offensive Tuesday on Mabuja, a village in the same province where various sects have long coexisted. Central Syria is a patchwork of communities, with many minority Christians as well as Ismailis and Alawites, both Shiite offshoots. These communities mainly back President Bashar Assad, himself an Alawite, and fear attacks by extremists among the mostly Sunni rebels fighting to topple him.

State TV said the militants slaughtered 44 people, including women and children, in their attack Tuesday.

The Syrian Observatory for Human Rights said the dead included 37 civilians who were either shot dead, burned or stabbed before the militants withdrew. 

The director of the Britain-based group, Rami Abdel-Rahman, said many villagers were still missing but it was unclear if they were kidnapped by ISIS fighters.

He said the army repelled the ISIS attack and pushed them back.

The extremist group has seen its power rise in the chaos of the civil war. It now holds about one-third of Syrian territory, most of it in the north and east, and has beheaded scores of people in recent months.

Elsewhere, Syrian government forces fired surface-to-surface missiles and conducted airstrikes on the northwestern city of Idlib, killing more than a dozen people, activists said Tuesday.

The city was captured by Islamist fighters led by Al-Qaeda’s branch in Syria and the ultraconservative Ahrar al-Sham group Saturday after four days of intense shelling and fighting. Its capture was a major blow to Assad’s government, which has retained control of almost all the country’s major urban areas through four years of unrest.

Idlib, with a population of around 165,000 people, became the second provincial capital to fall to the opposition after Raqqa, which is now a stronghold of ISIS.

Yacoub El Hillo, the United Nations Humanitarian Coordinator in Syria, said he was “gravely concerned by the ongoing fighting” in Idlib, which he said has displaced some 30,000 people.

He said the situation in the city is becoming increasingly dire, with electricity shortages and the closure of schools and hospitals.

His comments came as activists and residents who fled the city said fighters were searching for government supporters, many of whom fled as the militants moved in.

In Geneva, the U.N.’s human rights office spokeswoman Cecile Pouilly said at a briefing that the U.N. was concerned about reports of an attack on a hospital run by the Syrian Arab Red Crescent in the city.

Syria’s Red Crescent published photos of destruction at its Idlib hospital on Facebook, but did not give details on how it had been damaged.

The Observatory and the Local Coordination Committees said Monday night strikes on Idlib killed at least 14 people.

State news agency SANA said “tens” of “terrorist groups’ members” were killed overnight and at dawn Tuesday during “successful” military operations in Idlib. The government refers to the entire armed opposition as “terrorists.” 

Elsewhere, the Syrian army secured a mountain range near Damascus in an operation against insurgents, state television said Tuesday, tightening control over an area important to Assad after the state lost Idlib.

The army launched a campaign last week to reclaim the Zabadani region, 50 km northwest of Damascus. It is part of an area near the border with Lebanon where the army has often clashed with insurgents including Nusra.

The area is important because of its proximity to the capital and its position on the border.

“Units of the army are in full control of the western mountain range of Zabadani,” state television said in a news flash quoting a military source. It said “a number of terrorists” had been killed.

The Observatory said there were ongoing clashes between Islamist groups and government forces backed by allied fighters in the mountain area and that there were reports the military had sent reinforcements.