Is the patient who is on dialysis twice a week obliged to observe fasting? Is his fasting on the days he is on dialysis considered valid or not?

Praise be to Allah the Lord of the Worlds.

Dialysis invalidates fasting because of the nutritional fluid used in that procedure, as pointed by specialized doctors, in addition to causing bodies to enter the stomach. Therefore, it is recommended that the patient who had undergone dialysis to observe fasting for the rest of that day, if he is able to, and make up for it after Ramadan. However, if the doctor told him that fasting, at any time, would damage his health, then he must break his fast and pay a ransom against every missed day. We pray that Allah blesses this person with recovery. And Allah The Almighty Knows Best.

Is it permissible for a Muslim physician to specialize in gynecology obstetrics, and what is the ruling on working as such?

Some fields of knowledge are an individual duty while others are a collective one, and specializing in gynecology obstetrics is a collective duty. However, if there were female physicians to treat women, then there is no need for a male gynecology obstetrics specialist to look at women`s Awrahs (private parts) except in necessary situations since the jurisprudential maxim says:” Necessity must only be assessed and answered proportionately.” And Allah Knows Best.

Is washing both openings (Istinjaa`) a must before every ablution?

Washing the front and back openings (Istinjaa`) is a must in case they have an impurity, but if they do not, there is no need for that, and Istinjaa` is not a condition for the validity of ablution.

I made a vow "If the Israeli troops retreated out of Gaza strip I will buy a cake from a certain bakery" and it happened. Am I obliged to buy from the same bakery?

You are obliged to buy from the same bakery. And Allah Knows Best.