Okay I have all the medals and I still don't know how to consistently get many of them. Obvious medals are obvious so figure those out yourselves.
As for the rest, it seems each time you get to the puzzle it's random, and then once you solve that the next time through will be random (though it depends on the last number you land on in the puzzle), and if it randomly starts you with certain things, that's how you get all except the last medal. Basically just keep playing the game a lot.
My best guess on how to get the last medal is you have to win so many times in a row.
So okay there's really no good strategy in this game. If you try to shoot or punch you'll just take more damage. So the best you can do is just run to the right and hope you make it. However depending on your rebirth scenario this won't make it in certain scenarios. I believe you're just screwed if you rebirth into a scenario where this strategy doesn't work as there's no other even halfway decent strategy. So winning the game is pretty much luck.
Gameplay is pretty bad and so is the art.
Music is decent.