Assume that only pen/pencil and paper may be used for this question. (i.e., no numeric solvers.)
Demonstrate that $$\dfrac{9x^2\sin^2x + 4}{x\sin x}$$ has a local minimum for $0 < x < \pi$.
My attempts. Let $y = x\sin x$ (which we observe is $> 0$ over the given interval) and $$f(y) = \dfrac{9y^2 + 4}{y} = 9y + \dfrac{4}{y}\text{.}$$
We observe that, letting $y = x\sin x$, that if $f(y) = 9y + \dfrac{4}{y}$, then $$f^{\prime}(y) = y^{\prime}\left(9 - \dfrac{4}{y^2} \right)\text{.}$$ Clearly this equation's roots are when either $y^{\prime} = 0$ or $9- \dfrac{4}{y^2} = 0$. I focus on $y^{\prime}$. We have $$y^{\prime} = \sin x + x\cos x\text{.}$$ Since $\sin x > 0$ and $x > 0$, the sign is completely determined by $\cos x$. Obviously $y^{\prime} > 0$ for $0 < x < \dfrac{\pi}{2}$; we then observe that $$y^{\prime}\left(\dfrac{3\pi}{4} \right) < 0 $$ so by the intermediate value theorem, $y^{\prime}$ is positive from $(0, c)$ and negative from $(c, \pi)$ for some $0 < c < \pi$.
I am not sure how to deal with analyzing $9 - \dfrac{4}{y^2}$ by hand, and I'm not satisfied with my analysis of $y^{\prime}$.
You can argue using AM-GM:
You have for $y= x\sin x$
$$9y+\frac 4y \stackrel{AM-GM}{\geq} 2\sqrt{9y\cdot \frac 4y}=12$$
Equality is achieved for $$9y=\frac 4y \stackrel{y>0}{\Leftrightarrow } y=\frac 23,$$ which lies in the image of $(0,\pi)$ under $x\sin x$.