Are there really still only four forces in the universes?
So far, we have managed to explain all observed interactions with reference to just four basic interactions (although, now I come to think about it, I don't know exactly where the Higgs interaction fits into that). There is currently no compelling scientific reason to introduce a "fifth force" into our models.
That's not to say we have a complete understanding of our universe, of course. Currently, it appears we have quite a big problem with dark matter and dark energy, but we currently don't have comprehensive models of either of those things.
Or are all of them except for gravity reducible now to one force?
The electromagnetic and weak interactions are unified in electroweak theory. In a sense, the Standard Model of particle physics explains the electroweak and strong interactions but not, as far as I'm aware, in a completely unified way. A unified theory of the strong and electroweak interactions would be what is often called a "Grand Unified Theory" or GUT.
Our best current theory of gravity is not a quantum theory, and that presents a significant barrier to the creation of a so-called "Theory of Everything" (TOE). There are, of course, attempts to incorporate gravity into the quantum picture, such as string theories. But those are still speculative.
What is a force anyway? What is their medium of transmission across space?
Each of the four interactions, in quantum theory, is "mediated" by the exchange of "force carrier" particles that are transmitted between the particles that are affected by each interaction. None of the fundamental forces require a particular "medium" for transmission; all can be transmitted in a vaccum.
No. Charge is a property of fundamental particles that are affected by the electromagnetic interaction. Fundamentally, electromagnetic forces only act on things that have electric charge.
In a similar vein, "colour charge" is a property possessed by quarks, and only particles that have that property are affected by the strong interaction.
Mass is the kind of "charge" that the gravitational interaction acts on.
Inertia is an effect of mass. Mass, in the modern picture, is a property that some particles gain through their interaction with the Higgs field.
What about the Casimir Effect?
I'd have to look that one up.
Are quantum fluctuations a force?
No, but I guess forces can result from some kinds of quantum fluctuations.