ISLAMABAD, PAKISTAN - Against the backdrop of a lethal strike by Taliban extremists, Pakistan's fractious ruling coalition appeared to splinter anew Tuesday after acting in concert a day before to oust President Pervez Musharraf.

Although Musharraf's resignation in the face of an impeachment threat was widely seen as marking the start of a new era, Tuesday's events clearly demonstrated that some unpleasant on-the-ground realities remained unchanged.

In volatile northwest Pakistan, where government forces have been locked in an escalating confrontation with Islamic extremists, a suicide bomber entered a hospital emergency ward and blew himself up, killing at least 32 other people, authorities said.

The attack in the town of Dera Ismail Khan, which lies near Pakistan's tribal borderlands, coincided with the most intense fighting in years in some areas abutting the Afghan frontier. The Taliban claimed responsibility for the bombing, demanding that the government call off military offensives in the tribal area of Bajur and in the Swat Valley, about 100 miles north of the capital, Islamabad.

Word of the hospital bombing came as coalition leaders met in Islamabad for their first major policy talks since Musharraf's ouster. No signs of consensus emerged on the question of a successor for the former president, who until late last year had also been the military chief.

Under the constitution, a new president is to be selected within 30 days.

Within the coalition, open disagreement flared over the question of reinstating judges fired by Musharraf last year. The junior party in the coalition, led by former Prime Minister Nawaz Sharif, has demanded the immediate restoration of the previous judiciary. But the Pakistan People's Party, led by Asif Ali Zardari, has taken a much more cautious tack, saying many technical issues still need to be resolved before the judges can be returned to the bench.