EXHIBIT 4.5

                                LETTER AGREEMENT


     This Agreement is entered into between  America's  Shopping  Mall,  Inc., a
Nevada Corporation (formerly Advanced Medical Sciences,  Inc.) and Initio, Inc.,
a Nevada Corporation.

     WHEREAS, the parties hereto had heretofore entered into a certain Agreement
of Purchase and Sale dated May 21, 1999; and

     WHEREAS,  a difference of opinion regarding the interpretation of paragraph
3.1(i) of the Convertible  Debenture  concerning the initial conversion price of
therein has arisen;

     NOW THEREFORE, the parties hereto do hereby agree as follows:

     1)   The conversion  price shall be $5.50 per share (after giving effect to
          the 1 for 30 exchange),  provided,  however,  if on or before December
          31, 1999 America's  Shopping Mall shall repay to Initio  $400,000 plus
          interest  accrued to the date of such  payment,  thereby  reducing the
          present  indebtedness  from  $3,400,000 to  $3,000,000,  then, in that
          event the initial  conversion  price shall be increased  from $5.50 to
          $6.00.


                                          America's Shopping Mall, Inc.


                                          /s/ Irwin Schneidmill
                                          -----------------------------
                                          By: Irwin Schneidmill,
                                              President & C.E.O.


                                          Initio, Inc.,


                                          /s/ Martin Fox
                                          -----------------------------
                                          By: Martin Fox,
                                              President & C.E.O.




Dated: July 22, 1999

Terms herein above confirmed
and agreed to:


- ----------------------------
     Jim Patten