Ethnic Armenian officials in the enclave of Nagorno-Karabakh said on Monday that 45 more servicemen had been killed in fighting with Azerbaijan, bringing its total military death toll to 525 since fighting broke out on Sept. 27. At least 25 civilians have been killed and more than 100 wounded since then. The fighting has surged to its worst level since the 1990s, when some 30,000 people were killed.