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Fighting raged on Saturday around Gaza's main hospital where Israel says it has so far killed more than 170 gunmen in an extensive raid, which the Palestinian Health Ministry says has also resulted in the deaths of five patients.
The armed wing of Hamas and the Islamic Jihad said their fighters were engaged in battles with the Israeli forces outside and around the vicinity of Al Shifa hospital in Gaza City, though Hamas denies any presence inside the facility.
Israeli troops stormed Al Shifa in the early hours of Monday morning and have been combing through the sprawling complex, which the military says is connected to a tunnel network used as a base for Hamas and other Palestinian fighters.
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The Gaza health ministry said five wounded Palestinians "besieged" inside Al Shifa died as a result of being denied proper care, water and food for the past six days and that the condition of other injured patients was deteriorating.
The Israeli military, which has lost two soldiers in combat at the hospital, says it is preventing harm to civilians, patients and medical staff there and providing them with food, water and adequate access to healthcare.
Reuters has been unable to access the hospital and verify either account.
Al Shifa, the Gaza Strip's biggest hospital before the war, is now one of the few healthcare facilities even partially operational in the north of the territory, and had also been housing displaced civilians.
Residents living nearby said Israeli forces blew up dozens of houses and apartments in the streets around the hospital and bulldozed roads. They said a nearby private medical center, Al Helo Hospital, was also hit by the army.
The Hamas-run Gaza government media office said Israeli tanks hit several buildings at Al Shifa Hospital and set fire to a surgery department and that around 240 patients and their companions as well as dozens of healthcare staff had been detained.
The Israeli military said that more than 350 Hamas and Islamic Jihad militants have so far been detained at the hospital and a total of 800 people have been questioned.
In recent days, Hamas spokespeople have said that the dead announced in previous Israeli statements were not fighters but patients and displaced people.
Israel faced heavy criticism last November when troops first raided the hospital. The troops uncovered tunnels there, which they said had been used as command and control centres by Hamas.
Israeli forces shot and killed Palestinian pharmacologist, Mohammad Al Nono outside Al Shifa hospital after they ordered him to evacuate, along with some colleagues, his family said. A member of the family said they learned about his death from other doctors. The Israeli military had no immediate comment.
Nono is the brother of Taher Al Nono, who serves as the media adviser to Hamas's political chief Ismail Haniyeh.
Hamas media said elsewhere in Gaza City, seven Palestinians were killed on Saturday and several others wounded at the Kuwait roundabout while they waited for aid trucks.
"We survived death, they shot at us, there are many martyrs, there are many injured, we almost died to get our children a bite to eat," said Alaa Al Khoudary, a resident of Gaza City who had just returned from the Kuwait roundabout carrying a bag of aid.
In Rafah, where over a million people have been sheltering, health officials said an Israeli airstrike on a house killed eight people and wounded others.
The Israeli military said that it killed at least 20 gunmen in airstrikes and close-encounter combat in central Gaza and in the southern area of Khan Younis.
More than 32,000 Palestinians have been killed since the start of Israel's offensive in the Gaza Strip, according to health authorities in the Hamas-ruled enclave.
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