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.

What is the ruling of Sharia on tubal ligation?

*Tubal ligation is a surgical procedure for female sterilization in which the fallopian tubes are permanently blocked, clipped or removed. This prevents the fertilization of eggs by sperm and thus the implantation of a fertilized egg. Tubal ligation is considered a permanent method of sterilization and birth control.

What should a praying person who doubts having offered one, or two prostrations in the third Rakah (unit of prayer) do?

Whoever has doubts about their prayer should consider what is less i.e. the above person should offer another Sajda (prostration) and complete his/her prayer, then offer Sujood As-Sahw (prostration of forgetfulness). And Allah Knows Best.

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.