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.

Does the time of Fajr (dawn) prayer start after the first Athaan (call for prayer), or the second one?

All perfect praise be to Allah,The Lord of The Worlds                                                                                                                                                                    The time of Fajr prayer starts after the second Adhan. And Allah 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.

I went to the health center today to take an intramuscular injection of Neurorubin B12. The nurse told me that this type of injection breaks the fast because it nourishes the body. Is this true? I have heard that intramuscular injections do not break the fast, but I was unsure about this type, so I decided not to take the injection.