What is the ruling on performing istinja' with perfumed tissues or a tissue moistened with water?
Performing istinja' with perfumed or moistened tissues is not sufficient if they are not dry, due to the moisture on them reaching the impurity, which increases its spread rather than reducing it. Then, to remove the impurity, one must use pure water. And Allah the Almighty knows best.
Must a person refrain from eating for the rest of the day if they break a fast of a vow (nadhr) or a make up fast (qada)?
Whoever observes a vowed fast (nadhr) or a makeup fast (qada) is prohibited from breaking it without a valid excuse. If they break it without a legitimate reason, they are sinful.
However, they are not required to refrain from eating for the rest of the day, because such restraint is only required out of respect for the month of Ramadan, not for other types of fasting.
What is the ruling on one who sees moisture on his clothes and doubts whether it is semen or pre-seminal fluid (madhy)?
Whoever finds moisture upon waking from sleep and doubts whether it is semen or madhy, and cannot distinguish between them, he may choose between them and act according to his choice. If he wishes, he can consider it semen and perform the ritual bath, or consider it madhy, perform ablution, and wash what it has soiled. This is because if he fulfills the requirement of one of them, he is definitively free from it, and the default is his innocence from the other. And Allah the Almighty knows best.
Does an internal medical examination for a woman affect her fast?
An internal medical examination for a woman invalidates the fast because it involves the entry of a foreign object into the body cavity (jauf) while fasting.
In this case, the woman must refrain from eating and drinking for the rest of the day out of respect for Ramadan and make up for the missed fast after Ramadan.
Such an examination should be avoided in Ramadan and other months unless absolutely necessary, as exposing the private parts is only permissible in cases of necessity.
If necessary, a woman should seek a Muslim female doctor first. If one is unavailable, she may see a female doctor from the People of the Book (Jews and Christians). If neither is available, she may consult a trustworthy and competent Muslim male doctor.